405802134-1-5-2026-29-AS-KBUY-DQTLTZ-20260130080309

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405802134
Report Date: 01/05/2026
Date Signed: 01/05/2026 02:04:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/26/2025 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20251226142648

FACILITY NAME:	SUNRISE TERRACE RCFE VII		FACILITY NUMBER:	405802134
ADMINISTRATOR:	INGAN, EDWIN		FACILITY TYPE:	740
ADDRESS:	1557 16TH ST		TELEPHONE:	(805) 534-9952
CITY:	LOS OSOS	STATE: CA	ZIP CODE:	93402
CAPACITY:	6	CENSUS: 2	DATE:	01/05/2026
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Edwin Ingan		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Facility is not serving residents meals of good quality or quantity of food at dinner time.
Facility is not providing activities to residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon conducted a 10-day complaint visit to the facility above. LPA met with Edwin Ingan and explained the purpose of the visit.

LPA requested the following records: Staff Roster, Staff Schedule, Resident Roster, All Residents Admission Agreement, Pre-Placment Apprisal, Functional Capabilites Assesment, Current Apprisal, Needs and Service plans, Sample food menu and if avaiable a sample activties calendar.
LPA interviewed Residents and staff.

On the allegation: Facility is not serving residents meals of good quality or quantity of food at dinner time. LPA checked the food at the facility, the facility has 2 day persiasbhable, 7 day non-perishables, food is covered, stored and marked apporiately. The selections of food present is in good quantity to make quality meals that meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. Continued 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20251226142648

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE TERRACE RCFE VII	FACILITY NUMBER: 405802134
	VISIT DATE: 01/05/2026

NARRATIVE

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The facility cooks and prepares 3 meals with snacks available daily. LPA interviewed residents which revealed they get three meals a day and have options if the resident does not like what is being served, the food is enough to eat and someone can get more if wanting. The residents like the food that is served and the options that are available if the residents do not like something being served. LPA reviewed records the facility has a daily activity calendar with times of meals and activities according to the preferences of the residents in care. The admission agreements were reviewed and indicate 3 meals a day with snacks daily. Based on a lack of evidence and the residents having options at meals this allegation is deemed Unsubstantiated at this time.

On the allegation: Facility is not providing activities to residents in care. LPA interviewed residents which revealed the facility does offer games, puzzles, group communication, outside patio time and walks around the facility. Residents interviews stated the residents gets to chose to do what the residents wants to do and a resident prefers not to play with puzzles and games and would rather watch TV or go out to the patio. Residents interview revealed the resident would rather ride a stationary bike, go into the community shopping or take walks. The facility staff interviews revealed the facility will accommodate the residents in whatever the residents want to do, residents sometimes do not want to go anywhere or do not want to get out of bed that day and the staff allow the residents to do what the residents want to do. LPA reviewed records the facility has a daily activity calendar with times of meals and activities according to the preferences of the residents in care. The admission agreement was reviewed and stated the facility offers a planned activity program. Based on the lack of evidence and resident preferences being met this allegation is Unsubstantiated at this time.

Exit interview and copy of report printed for Administrator.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2026

LIC9099 (FAS) - (06/04)

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