Sunshine Board and Care Harbor LLC

We haven’t transcribed this report yet. The complete document is on the state’s site.

Type of visit: Required - 1 Year

On September 22, 2026, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced 1 Year Required annual inspection visit. LPA met with caregiver Filipina Dela Rosa. LPA explained the purpose of today’s visit. The facility is licensed to operate for (6) non-ambulatory of which (1) maybe bedridden elderly adults ages 60 and above. The facility is approved for (6) hospice resident. Currently there is no hospice resident in care. The facility is a single-story structure located in a residential neighborhood. It consists of the following: (4) residents' rooms, (2) bathrooms, (1) staff bedroom, a living area, a dining area, a kitchen, and a garage used for storage. LPA toured the physical plant. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the resident's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 105.0 degrees F. A comfortable temperature of 75 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. Fire extinguishers were charged. (Evaluation Report continues LIC 809-C) A working landline phone was operable. The facility is current on CCL License dues. The facility has a commercial liability insurance policy #825AL valid 07/12/26 through 07/12/27. The facility has conducted fire drills 08/20/26. An audit of residents #1-#5 (R1-R5) service files. DEFICIENCIES: Top lock for kitchen drawer is inoperable were sharp objects and knives are stored. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies has been observed and citation issued (ref. LIC 809-D). Due to time constraints, LPA was unable to complete the visit and will return at another unannounced time. An exit interview conducted with Ruby Ann Punzalan a copy of report and appeal rights provided.the state’s words, verbatim · CDSS document, Sep 22, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(a) · Plan of correction due date: Oct 6, 2026

87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement is not met as evidence by: Based on observation, Licensee did not have a working lock for kitchen drawer that stored sharp objects. This violation possesses an immediate Health and Safety risk to residents in care.the state’s words, verbatim · CDSS document, Sep 22, 2026

Plan of correction: Licensee must comply with Title 22 Section 87303 and repair kitchen drawer lock. Proof of correction, must be submitted by the due date of 10/06/26 to 424-544-1016.

Type of visit: Required - 1 Year

On 11/06/2025 at 11:40 AM, Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced annual inspection visit at the Sunshine Board and Care Harbor Facility. LPA Calderon was allowed entry into the facility by Administrator Rustico Punzalan. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and over of which one (1) may be bedridden in room #3. It has a hospice waiver for six (6) residents. Currently, there are five (5) residents residing in the facility. LPA Calderon explained to Administrator Rustico Punzalan the purpose of the one-year Annual Inspection visit, and escorted LPA Calderon on a tour of the entire inside and outside facility grounds. As part of the inspection, LPA Calderon reviewed: Five (5) client service records, five (5) client medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. The facility’s last fire drill was conducted on 10/21/2025. The one-story residential home consists of five (5) client bedrooms, two (2) client bathrooms, living room, dining room, kitchen, staff room, office area, attached garage with washer and dryer/ storage area, backyard with table and chairs. No weapons are stored or found on the premise grounds. The kitchen was inspected and observed to be clean and operational. A two-day supply perishable and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage area. LPA Calderon observed that all facility rooms are clean and in good repair. A comfortable temperature was observed, and the facility has central air and heating. LPA Calderon observed the following during inspection of client’s rooms: mattresses are in good condition, adequate lighting present, plenty of dresser/closet space is present, and all bed linens present. All bedrooms contain furniture, lighting fixtures and personal storage space as required, all beds have the required amount of linen and mattress covers, LPA Calderon observed fully stocked closet with bedding, towels, and toiletries supplies. Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. LPA Calderon observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 105 degrees Fahrenheit; bathroom #2 hot water temperature properly measured at 105 degrees Fahrenheit. Kitchen hot water temperature properly measured at 105 degrees Fahrenheit. Facility one (1) Carbon Monoxide and six (6) Smoke Detectors, hard-wired and connected, were tested and working properly. Facility one (1) Fire Extinguisher was checked and found to be fully charged and accessible. All exit doors in the facility have alarm systems. The facility has a working landline/ telephone. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility one (1) first aid kits are fully stocked with manuals being checked and in order. Outside grounds were toured and no bodies of water were observed. All Exits/ Walkways around the home were free of debris and hazards. Outside patio accessible to clients. Five (5) client files were reviewed and found to be complete. LPA Calderon reviewed five (5) resident medications (MAR) and they were all found to be administered according to doctor's orders. Three (3) staff files were checked, and they have the required documents. LPA Calderon noted the Administrator Rustico Punzalan Certification # 7027370740 expiration date of 01/14/2026 was valid at time of inspection. Commercial General Liability Policy #001457632 policy period from 07/12/2025 to 07/12/2026 underwritten by James River Insurance Company, coverage 1,000,000/3,000,000 is valid at time of inspection. All the required documents are posted in the facility in a clearly visible area. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA Calderon did not observe deficiencies therefore no citations were issued at this time. Annual Licensing Fee is CURRENT. An exit interview was conducted, and a copy of the Facility Evaluation Report was provided to Administrator Rustico Punzalan.the state’s words, verbatim · CDSS document, Nov 6, 2025

Type of visit: Required - 1 Year

On 11/21/24, Licensing Program Analyst (LPA) Regina Cloyd conducted an unannounced required – annual inspection and met with Assistant Administrator Ruby Punzalan. The facility is licensed to operate for six (6) non-ambulatory residents ages 60 and over of which one (1) may be bedridden in room #3. It has a hospice waiver for six (6) residents. The facility is a one-story house located in a residential neighborhood and consists of four (4) resident bedrooms, one (1) staff bedroom, two (2) bathrooms and a two-car garage. The home also consists of a living room, dining room, and kitchen. The facility is clean, sanitary, and in good repair. Staff accompanied LPA inside and outside the facility during this inspection. Outside grounds were toured and no bodies of water were observed. Walkways around the home were clear of hazards. Resident bedrooms had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. There are no security bars or weapons on the premises. Resident bathrooms were checked. Toilets and water faucets worked properly, grab bars were secure, shower was free of mold/mildew and a non-skid mat was in place. Resident bath towels, toiletries, and personal hygiene supplies were adequately stocked. Common areas were clean and clear of hazards, doorways were free of obstructions. Continue to LIC809-C. LPA toured the kitchen area and observed a two-day supply of perishable and a seven-day supply of non-perishable food. Knives and toxins were kept in locked storage cabinet. First Aid kit was available. One fire extinguisher, last serviced October 9, 2024 was observed in the living room, the hallway, and in the kitchen area. Staff tested the carbon monoxide detector and smoke detectors in the house. Both devices were functional. Five staff records were reviewed, and five out of five staff records had the required criminal record clearances or criminal record exemptions. Five resident records were reviewed, and five out of five resident records had medical assessments. Two residents’ medication was reviewed. No deficiencies are being cited. An exit interview was conducted, technical assistance provided, and a copy of this report was discussed and left with the Assistant Administrator Ruby Punzalan.the state’s words, verbatim · CDSS document, Nov 21, 2024

Type of visit: Required - 1 Year

On 11/17/2023 at 11:11 AM, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced annual required visit using the CARE Inspection Tool. LPA met with Caregivers Vanessa Vidanes and Edson Vidanes. LPA explained the purpose of today’s visit. Administrator/Licensee Rustico Punzalan and Licensee Ruby Punzalan arrived later and joined the visit. The facility is licensed to operate for six (6) residents ages range 60, six (6) non-ambulatory of which one (1) may be bedridden, hospice waiver for six (6). Currently, there are five residents. Three out of five residents are non-ambulatory, no bedridden and no hospice residents. The facility is a one-story house located in a residential neighborhood and consists of four (4) resident bedrooms, one (1) staff bedroom, two (2) bathrooms and a two car garage. The home also consists of a living room, dining room, and kitchen. At around 11:15 AM, LPA toured the physical plant with Caregiver Vanessa Vidanes. There were no bodies of water on the premises. All rooms were inspected. Beds and bedding supplies were in operational condition, lighting was provided, and storage for the client's personal belongings was observed. Bed linens, comforters, and bath towels were available during the visit. Bathrooms were operational with water temperature measured at 112.1 degrees F. A comfortable temperature of 76 degrees F. was maintained in the facility. LPA observed the facility to be furnished at the time of the visit. Storage areas for personal hygiene and sharps objects were stored and not accessible to residents. The kitchen was inspected, and sufficient perishable and non-perishable food was maintained adequately. A fire extinguisher was charged. A review of the Medication Records Administration (MAR) was observed to be maintained in place. (Evaluation Report continues LIC 809-C) During the visit, LPA observed the facility's infection control practices. LPA observed screening protocols for visitors, staff, and residents, and sanitizing stations in common areas and restrooms. LPA observed the facility has a 30-day supply of Personal Protective Equipment (PPE). All mandated inspection control posters were posted. LPA observed First Aid Kit was maintained. A working landline phone (424-378-1145) is operational. The last fire drill was conducted on 10/10/2023. The facility had operational smoke and carbon monoxide in bedrooms and common areas. The facility has current liability insurance on file effective 7/12/23-7/12/24. The facility is current on Community Care Licensing annual dues. An audit of resident #1-#5 (R1-R5) service files and staff #1-#4 (S1-S4) personnel files revealed to be complete. Interviews were conducted with two residents and two staff. The facility has the current administrator's certification #6062032740 with expiration date of 1/14/2024. According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed deficiency and issued a citation, deficiency is on the LIC 809D. An exit interview was conducted with Administrator Rustico Punzalan, and a copy of the report was provided.the state’s words, verbatim · CDSS document, Nov 17, 2023