<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 134604417
Report Date: 08/24/2023
Date Signed: 08/24/2023 01:52:59 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/07/2022 and conducted by Evaluator Renita Hall
COMPLAINT CONTROL NUMBER: 08-AS-20221107144926
FACILITY NAME:SONRISA VILLA INC.FACILITY NUMBER:
134604417
ADMINISTRATOR:GUEVARA, ITZELFACILITY TYPE:
740
ADDRESS:708 E. 5TH ST.TELEPHONE:
(760) 756-3285
CITY:HOLTVILLESTATE: CAZIP CODE:
92250
CAPACITY:175CENSUS: 103DATE:
08/24/2023
UNANNOUNCEDTIME BEGAN:
01:46 PM
MET WITH:Gabriela Zamora, ManaerTIME COMPLETED:
01:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is not maintainng patio in a safe, or sanitary condition.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Renita Hall conducted an unannounced visit to deliver findings. LPA was allowed entry Gabriela Zamora, Manager LPA identified herself and disclosed the purpose of the visit and elements of the findings with the Manager.

On November 7, 2022 it was alleged that staff are not maintaining patio in a safe, or sanitary condition. The Department’s investigation consisted of record reviews, interviews with staff and residents and observations. LPA's observation on November 9, 2022 the patio area exposed to elements which posed a potential safety risk to residents. The patio wooden benches were in disrepair; tools used for cleaning and repair were observed throughout patio area and were not locked up as required.

On 02/03/2023 LPA verified and observed that corrections were made to these areas.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 08-AS-20221107144926
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SONRISA VILLA INC.
FACILITY NUMBER: 134604417
VISIT DATE: 08/24/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Observations concluded the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

An exit interview was conducted with Gabriela Zamora, Manager. A copy of this report and Licensee's Rights (LIC 9058 03/22) were provided to the Manager and her signature on this report confirms receipt of the Licensee Rights.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 08-AS-20221107144926
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SONRISA VILLA INC.
FACILITY NUMBER: 134604417
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/24/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/24/2023
Section Cited
CCR
80087(c)(a)
1
2
3
4
5
6
7
c) All outdoor and indoor passageways, stairways, inclines, ramps, open porches and other areas of potential hazard shall be kept free of obstruction.(a)The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.
1
2
3
4
5
6
7
Licensee will maintain facility patio by keeping it free and clear of debris, wooden benches in good repair, gardening tools locked up and exposed wires covered. LPA Observed corrections on February 3, 2023
8
9
10
11
12
13
14
This requirement was not met as evidenced by: Based on observation
review, the licensee did not ensure that
patio was safe, or sanitary condition, which posed an immediate Health, Safety and Personal Rights Risk to person in care. Safety risk residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Denise Powell
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3