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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306005811
Report Date: 05/19/2021
Date Signed: 05/19/2021 12:59:57 PM

Document Has Been Signed on 05/19/2021 12:59 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:MORNING SUNRISE VILLAFACILITY NUMBER:
306005811
ADMINISTRATOR:GRANVILLE, NIDAFACILITY TYPE:
740
ADDRESS:9061 ORANGEWOOD AVE.TELEPHONE:
(714) 530-7522
CITY:GARDEN GROVESTATE: CAZIP CODE:
92841
CAPACITY: 6CENSUS: 5DATE:
05/19/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Nida Granville TIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Albert Marin made an unannounced visit to this facility to conduct a case management in relation to Complaint No. 22-AS-20201006082346 filed against another licensed facility. LPA met with AD Nida Granville and stated the purpose of the visit.

On October 6, 2020 The Department received a complaint filed against facility number 306003887. With the change of ownership and issuance of license for this facility effective November 25, 2020, the complaint investigation continued and is now complete.

As part of the plan of correction on the deficiencies found with the old facility (306003887), technical advisory was issued in this facility.

LPA Marin discussed with AD Granville the Health and Safety Code Sections 1569.625 and 1569.69; and California Code of Regulation Section 87465. LPA also provided guidance on the utilization of the new Guardian system; and discussed best practices on medication assistance procedures of the facility.

No citation was issued on this visit.

LPA conducted an exit interview with AD Granville and copies of this reports, forms and regulations discussed were left in the facility.



SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Albert Marin
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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