Sunny Villa

Allegation investigated: Facility did not provide care and supervision resulting in a resident eloping and sustaining an injury

On May 8, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to initiate the investigation into the allegation listed above and to deliver the complaint findings. LPA was greeted and granted entry into the facility by staff after explaining the purpose for the visit. Administrator (AD) Hyo Kim was present and assisted on today's visit. During the course of the investigation, LPA interviewed staff, interviewed a witness, reviewed and obtained documents for this complaint such as resident records. Regarding the allegation, facility did not provide care and supervision resulting in a resident eloping and sustaining an injury, the following has been concluded: It was alleged that the facility did not provide care and supervision resulting in Resident #1 (R1) eloping and sustaining an injury on May 5, 2026. LPA was unable to interview R1 for this complaint, due to R1 moving out of the facility on May 7, 2026. LPA conducted a records review for R1. LPA observed that R1 was discharged from a skilled nursing facility and was admitted into this facility on May 4, 2026. CONTINUED ON LIC9099-C Substantiated Per R1's discharge summary report dated May 4, 2026, R1 had a diagnoses of vascular dementia and Parkinson's disease. It also states that R1 needs to be monitored for behaviors such as wandering, exit - seeking, and attempting to open doors. LPA conducted interviews with two staff who were present on May 5, 2026. Both staff interviewed confirmed that on May 5, 2026, at approximately 1:30 PM, R1 exited the facility without staff supervision. Both staff stated that they noticed R1 was missing approximately twenty minutes later at 1:50 PM and they began searching nearby areas. Both staff stated that they learned at approximately 2:50 PM, that R1 was transported to the hospital after a neighbor had witnessed R1 fell on the ground. Therefore, R1 was left without staff supervision for more than an hour, and was subsequently transported to the hospital after sustaining an unwitnessed fall. LPA conducted an interview with R1's Responsible Party, Witness #1 (W1). W1 confirmed that she was informed that R1 had went missing on May 5, 2026, and was transported to the hospital after sustaining an unwitnessed fall. Based on the evidence gathered during this investigation, the Department obtained sufficient evidence to substantiate the allegation that, facility did not provide care and supervision resulting in a resident eloping and sustaining an injury . The preponderance of evidence standards has been met; therefore, the above allegation is SUBSTANTIATED. A deficiency is being cited on the attached LIC9099-D page. A civil penalty in the amount of $500.00 is also being assessed for absence of supervision. An exit interview was conducted with Administrator Hyo Kim. A copy of the report and appeal rights were provided at time of visit.the state’s words, verbatim · CDSS document, May 8, 2026 · control 22-AS-20260506115738

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87464(f)(1) · Plan of correction due date: May 9, 2026

87464 Basic Services: (f) Basic services shall at a minimum include: (1) Care and supervision as defined in Section 87101(c)(3) and Health and Safety Code section 1569.2(c). This requirement is not evidenced by: Based on interviews and records reviewed, the Licensee did not ensure that R1 was adequately supervised on May 5, 2026, despite R1 being diagnosed with dementia and having a behavioral history of wandering. This posed an immediate health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, May 8, 2026

Plan of correction: The Administrator stated that she will conduct an in service training with all staff regarding resident supervision. The Administrator agreed to provide LPA proof of the in service training via email or fax by POC date.

Type of visit: Case Management - Deficiencies

On May 8, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct a Case Management - Deficiencies visit. The visit is being conducted in conjunction with complaint control number 22-AS-20260506115738. Administrator (AD) Hyo Kim was present and assisted on today's visit. During the investigation into complaint control number 22-AS-20260506115738, LPA requested to review the file for Resident #1 (R1). LPA was informed that R1 moved into the facility on May 4, 2026, however, the facility only had a discharge summary report dated May 4, 2026 on file for R1. The AD informed LPA that the facility did not have an admission agreement, medical assessment, or pre-admission appraisal for R1. The AD also informed LPA that R1 moved out of the facility on May 7, 2026. Based on the information gathered during the visit, a deficiency is being cited on the attached LIC809-D page. An exit interview was conducted with Administrator Hyo Kim. A copy of the report and appeal rights were provided at time of visit.the state’s words, verbatim · CDSS document, May 8, 2026

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87506(b) · Plan of correction due date: May 15, 2026

87506 Resident Records: (b) Each resident’s record shall contain at least the following information: This requirement is not evidenced by: Based on interviews and records reviewed, the Licensee did not ensure that R1 had all the required records on file including the admission agreement, medical assessment, and pre-admission appraisal. This poses a potential health, safety, and personal rights risk to persons in care.the state’s words, verbatim · CDSS document, May 8, 2026

Plan of correction: The Administator stated that she will complete a statement of understanding regarding the regulation and will ensure that all required resident records are received prior to admission. The Administrator agreed to provide LPA the statement of understanding via email or fax by POC date.

Type of visit: Required - 1 Year

On January 5, 2026, Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to the facility to conduct the required annual inspection. Administrator Hyo Kim was notified via telephone and later arrived to assist with the inspection. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents, and has a hospice waiver for six. The facility is a two story home with three private resident bedrooms, three resident bathrooms, two of which are private, a living room, a dining room, a kitchen, a staff office, a laundry room, a courtyard patio, a casita, and an attached two car garage. The second story of the facility is for staff use only and is used for storage. On today's visit, LPA observed that the facility was vacant and that there were no resident's currently in care. LPA was informed by the AD during the visit that the last resident left the facility on December 1, 2025. The AD also informed LPA that they intended on submitting a Change of Ownership application in the near future. LPA accompanied with AD conducted a walk-through of the interior and exterior portions of the facility and confirmed that the facility is not in operation and that there are no residents in care at the time of visit. LPA advised the AD to notify the department if they admit a resident in the future to ensure the facility remains in compliance. Based on the observations made during today's visit, no deficiencies are being cited per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted with Administrator Hyo Kim and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jan 5, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Brandon Lopez made an unannounced visit to conduct the required annual inspection. LPA was greeted and granted entry by Administrator (AD) Yung Lee after explaining the purpose for the visit. LPA observed that Administrator Yung Lee has a valid Administrator certificate which expires on October 1, 2026. The facility is a Residential Care Facility for the Elderly (RCFE) licensed for six non-ambulatory residents with a hospice waiver for six. The facility is a two story home with three private resident bedrooms, three resident bathrooms, two of which are private, a living room, a dining room, a kitchen, a staff office, a laundry room, a courtyard patio, a casita, and an attached two car garage. The second story of the facility is for staff use only and is used for storage. LPA accompanied by the AD conducted a tour of the physical plant. On today's visit, LPA observed two residents in care, none of which are receiving hospice care, and the Administrator present. LPA observed residents relaxing in their respective bedrooms. LPA observed the See Something, Say Something poster (PUB 475) mounted on a wall in the dining room. LPA inspected all three resident bedrooms, and they were observed to be free of any hazards. LPA observed the resident bedrooms had the required furnishings of a bed, a chair, a chest of drawers, and a lamp. All resident beds had clean linens and blankets. LPA observed additional linens are stored in a hallway closet. LPA inspected the three resident bathrooms. Resident bathrooms are clean. Bathrooms are equipped with grab bars and non-skid floor mats. Faucets and toilets were operational. Hot water temperature measured between 107.4 and 108.2 degrees Fahrenheit. LPA observed a fire place in the living room which was adequately screened and not in operation. LPA observed the kitchen has a two day perishable and seven day nonperishable food supply on hand. LPA observed kitchen appliances to be clean and operational. The five burner gas stove lights unassisted. LPA observed kitchen knives are stored in a locked kitchen cabinet. LPA observed the facility has a three day emergency food and water supply stored in the kitchen pantry. CONTINUED ON LIC809-C A fire extinguisher is located in the kitchen, and it was observed the be charged and serviced as of September 20, 2024. LPA tested the wired smoke detectors/carbon monoxide detectors which tested operational. LPA tested the auditory alarms for both residents which tested operational. The centrally stored medication is kept in a locked hallway closet. LPA observed chemicals and toxins to be stored in a locked cabinet in the laundry room. The First Aid kit is stored in the staff office which was observed to have all the required components. The door leading to the attached two car garage is kept locked and inaccessible to resident in care. The garage is used for storage. LPA and AD conducted a tour of the exterior portion of the facility. LPA observed the exterior portion to be clear of obstructions and hazards. LPA observed the courtyard patio to have an outdoor shaded seating area with furniture for resident use. LPA observed a fire place in the courtyard patio which was observed to be adequately fenced and not in operation. LPA observed a shaded outdoor seating area with furniture for resident use in the backyard. LPA inspected the casita located in the backyard. The casita is for staff use only and is kept inaccessible to residents in care. The perimeter gate on the eastside of the facility is self-latching and can be opened in an evacuation. There are no bodies of water on the premises. LPA reviewed the two resident files. All the required documentation were present and current in the resident files reviewed. The facility handles medications for only one resident in care. LPA reviewed the one residents’ medication and medication records. LPA reviewed one staff files. All staff present are background cleared and associated to the facility. Based on today's observations, there are no deficiencies being cited per Title 22 of the California Code of Regulations. An exit interview was conducted with Administrator Yung Lee and a copy of the report was provided.the state’s words, verbatim · CDSS document, Jan 24, 2025

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection visit to follow up on corrections identified during visit on 12/15/2023. LPA arrived at the facility and was greeted and granted entry by Licensee Yung Lee and designated Administrator (AD) Young Park. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on 09/01/2023. The facility is a two-story house with three resident bedrooms, three bathrooms, living room, kitchen, dining area, office, laundry room, family room, and attached two car garage downstairs; upstairs is a staff bedroom with a bathroom. Facility also has an additional dwelling unit (ADU) in the backyard, ADU is a studio with one bathroom. At 9:00 a.m. LPA toured the facility and observed the following: · There is now lighting in three out of three resident bedrooms, and in the activity room. · Water temperatures tested at 111.2 degrees F. · Facility is two-stories, and second story consists of master bedroom for staff, facility has a signal system that is audible and identifies resident’s bedroom. · Downstairs master bedroom 3 has a chest of drawers, and chairs for residents. · All resident beds have the required elements including blankets and bedspreads. · Visiting policy is posted at the entrance of the facility. · Drawers and lock on file cabinet for medication are operable. · Five out of five gas stove burners are operable and refrigerator in garage has been removed from the facility. All noted items from visit on 12/15/2023 have been addressed. The facility is ready to be licensed. An exit interview was conducted and a copy of this report was left at the facility.the state’s words, verbatim · CDSS document, Dec 27, 2023

Type of visit: Prelicensing

Licensing Program Analyst (LPA) Claudia Gutierrez made an announced visit to the facility for purpose of conducting a pre-licensing inspection. LPA met with Licensee Yung Lee and designated Administrator (AD) Young Park. An application to operate a Residential Care Facility for Elderly (RCFE) for (6) capacity, (0) ambulatory, (6) non-ambulatory, and (0) bedridden residents was received by CCL on 9/01/2023. Structure: The facility is a two-story house with three resident bedrooms, three bathrooms, living room, kitchen, dining area, office, laundry room, family room, and attached two car garage downstairs; upstairs is a staff bedroom with a bathroom. LPA observed the See Something, Say Something poster (PUB 475) in the facility mounted on the wall in the dining area. There is a backyard with an exit gate on one side of the house. There is a shaded seating area and LPA did not observe any obstacles or hazards in the backyard. Resident Bedrooms Two out of three resident bedrooms had the required furnishings. One out of three resident bedrooms did not have a chest of drawers. LPA observed all beds had linens, however, three beds do not have blankets or bedspreads. LPA observed all windows were screened. Signal system There is no signal system. Toxins: All and any toxic chemicals, cleaning solutions, laundry toxins and disinfectants are inaccessible to residents and will be stored in the laundry room. Licensee will obtain a lock and key. Medications, First-Aid Kit & Book: Medication will be stored in a locked file cabinet. File cabinet was found to be inoperable. Designated AD stated it was defective and had ordered a replacement. First aid kit is stored in the dining area. The first aid kit has all the required elements. Resident & Staff Files: Records will be kept locked with medication. Pool/Jacuzzi: No bodies of water were observed. Fire Extinguisher: Fire extinguisher is fully charged. Reading Material, Games, Equipment & Materials: The facility has board games, books, and other recreational materials for the client’s use, stored in the living room. Fire clearance: Was approved by a fire inspector of Orange County Fire Authority on 10/01/2023. Special conditions noted, “Non-sprinkler. Built approx. 2004. OFC 435.8.3.4 exception.” Bedrooms Staff: Staff bedroom is located upstairs. Bathrooms: All bathrooms have working plumbing and designated hand washing posters. Hot water measured between 114.8-131.9 degrees Fahrenheit. Linens & Hygiene Supplies: A supply of extra linen was stored in the hallway storage. Emergency Phone Numbers, Exit Plan & Menu: Posted and available, means of exiting, emergency phone numbers and food menu. Food Service: A supply of 2-day perishable and 7-day of non-perishable food will be maintained on hand. Smoke Detectors: Smoke detectors and carbon monoxide detectors tested operational. Appliances: Two out of five burners on gas stove were inoperable. Refrigerator, dish washer, and microwave in the kitchen were operable. Washer, and dryer in laundry room are also operational. Refrigerator in the garage had unlabeled food items, with some of the items leaking fluids and had a noticeable odor upon opening and closing refrigerator door, designated AD stated they would not be using that refrigerator. Licensee to address the following corrections by 05/16/2023: · There is no lighting in two out of three resident bedrooms, and in the activity room. All rooms must have lighting. · Water temperatures tested at 131 degrees F in two out of three resident bathrooms. Water temperature to be adjusted to meet regulation of 105 to 120 degrees F. · Facility is two-stories, and second story consists of master bedroom for staff, therefore facility must have a signal system. · Downstairs master bedroom 3 does not have a chest of drawers, nor chairs for residents. Bedrooms must contain all required elements, including chest of drawers and chairs. · Two out of two beds in master bedroom 3 do not have blankets or bedspreads and bed in bedroom one does not have a bedspread. All resident beds must have the required elements including blankets and bedspreads. · Visiting policy is to be posted. · Drawers on file cabinet for medication are not operable. Cabinet drawers must be operable to allow facility staff access to resident’s medication. · Two out of five gas stove burners are inoperable and refrigerator in garage contains unlabeled food items and has a noticeable odor. Licensee to ensure facility is safe, sanitary and in good repair. LPA will make an additional announced visit to follow-up on corrections listed above. An exit interview was conducted, and a copy of this report was provided to designated AD.the state’s words, verbatim · CDSS document, Dec 15, 2023

Type of visit: Office

Component II completion: Successful Facility Type: RCFE Application Type: CHOW Capacity: 6 Census (if any clients in care): 0 COMP II Participants: Name - Yung Lee CEO/ Young Park Administrator Interview Method: Telephone interview On November 20, 2023, Applicant/Administrator participated in COMP II. Identification of the applicant and administrator was verified through interview questions based on photo ID and other identifying personal information. During COMP II, applicant and administrator confirmed that they have read and understand community care facility licensing laws included in the Health and Safety Codes and the California Code of Regulations Title 22. Signed LIC 809 with copy of photo ID have been obtained. During COMP II, CAB analyst confirmed Applicant/Administrator’s understanding of the following areas: 1. Facility operation: License type, client/resident populations, and program 2. Admission Policies 3. Staffing requirements & Training 4. Restrictive/Prohibited Health Conditions 5. General provisions 6. Emergency Preparedness 7. Complaints & Reporting 8. Pre-Licensing Readinessthe state’s words, verbatim · CDSS document, Nov 20, 2023