306005223-6-12-2026-22-AS-RMRT-DUYVZE-20260612165237

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 306005223
Report Date: 06/12/2026
Date Signed: 06/12/2026 04:52:44 PM

Document Has Been Signed on 06/12/2026 04:52 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
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME:	SUNNYCREST SENIOR LIVING		FACILITY NUMBER:	306005223
ADMINISTRATOR/ DIRECTOR:	AGUIRRE, MONICA		FACILITY TYPE:	740
ADDRESS:	1925 SUNNY CREST DRIVE		TELEPHONE:	(714) 992-1999
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY: 210		CENSUS: 103	DATE:	06/12/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:00 AM
MET WITH:	Melanie		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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	Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to conduct an Annual Required Evaluation. LPA was greeted and granted entry by the receptionist at 8am. LPA met with Executive Director (ED) Melanie Washington and explained the purpose of the visit. The facility is a two story building with a capacity of 210 non-ambulatory residents with an approved hospice waiver for 15 residents. LPA obtained staff and resident rosters. Currently there are 103 residents in care with nine residents on hospice. During today's visit, LPA toured the facility and inspected the physical plant. There are two elevators and three stairwells with evacuation chairs. Fire extinguishers were charged and inspected on September 15, 2025. Carbon monoxide detectors were tested and operational. LPA requested copies of current liability and vendor testing of smoke alarms/sprinklers. The Fire system was inspected on April 14, 2025 and passed. The facility is awaiting approval for 2026 fire inspection. The facility's last fire drill was conducted on May 25, 2026. The facility temperature was seventy-five degrees. The liability insurance is current through 12/23/2026. LPA tested the hot water temperature in five of five resident apartments. The temperatures measured between 107.1 to 113.6 degrees Fahrenheit. Resident apartments were clean, and had the required linens and furnishings. LPA did not observe medications in resident apartments. Resident bathrooms had grab bars and non-skid flooring. LPA observed the facility common areas were clean with no odors detected. LPA observed residents in the activity room engaged in activities and a resident outing to Trader Joe's. Residents came to the dining room for breakfast and lunch. (Continued on LIC 809-C)

NAME OF LICENSING PROGRAM MANAGER: Alisa Ortiz
NAME OF LICENSING PROGRAM ANALYST: RoseMarie Ruppert
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SUNNYCREST SENIOR LIVING	FACILITY NUMBER: 306005223
	VISIT DATE: 06/12/2026

NARRATIVE

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(Continued from LIC 809)

Upon entering the kitchen LPA observed staff cleaning up after the lunch service. Temperature logs were observed for the walk-in refrigerator/freezer as well as an additional refrigerator. The facility retained a minimum of two days of perishable items and the pantry had more than seven days of non-perishable food on hand. Emergency supplies are stored in the basement with water tanks. While touring the exterior LPA noted there were shaded seating areas and smoking areas in breezeways and in the courtyard.

LPA entered the medication room and audited medications. Controlled substances were secured and all medications were centrally stored. Per review medications are being given as prescribed. A First Aid Kit was mounted on the wall but there is also a designated cart for wound care and first aid. A First Aid book is stored in the medication room.

LPA reviewed six of six staff training and fingerprint records and ten of ten resident records. LPA interviewed alert residents regarding their quality of care and spoke to staff present regarding care provided. LPA confirmed the administrator has a current administrator certificate which expires on September 5, 2027.

Based on the observations made during today’s visit, the facility appears to be in compliance with Title 22 Division 6 of the California Code of Regulations, no deficiencies cited on this date. An exit interview was conducted with Melanie Washington, Executive Director and a copy of the report and files reviewed (LIC 858 & LIC 859) were given at the time of the visit.

NAME OF LICENSING PROGRAM MANAGER: Alisa Ortiz
NAME OF LICENSING PROGRAM ANALYST: RoseMarie Ruppert
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2026

LIC809 (FAS) - (06/04)

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