Sunshine Home II

Type of visit: Required - 1 Year

On 03/16/2026, at 2:58 PM, Licensing Program Analyst, (LPA) LaVette FArlow, (LPA) arrived at the Sunshine Home II, unannounced to conduct the Annual Inspection. LPA was greeted and granted entry by Caregiver Larnie Cunanan. Caregiver Larnie contacted Licensee Rosario Nicolas to notify of LPA arrival. Rosario requested to speak with LPA Farlow and inform LPA that the Administrator would assisted LPA with any questions or concerns. LPA conducted a general overall inspection with care staff, which included, but was not limited to, the following: Physical Plant: At 3:15 PM, LPA conducted a tour of the facility. The facility is comprised of 3 Resident Rooms, 1 Staff Bedroom, 2 Bathrooms, Kitchen, Dining Room, Living Rooms, Attached Garage, and Backyard. The facility maintains a partnership with the Inland Regional Center at a Level III (3). The facility is approved for six, (6) non-ambulatory, 1 bedridden resident and 1 wheelchair bound resident. LPA was informed the current census at the time of visit was 4. Resident were all present at the time of the visit. The facility is operating in the capacity approved by Community Care Licensing (CCL). Pathways inside and outside of the facility were free of obstructions. The facility was maintained at a comfortable temperature 78 degrees Fahrenheit. Resident Rooms were observed orderly and contained all required furnishings such as beds with proper linens, night stands, adequate storage space and lighting. The facility is equipped with functional smoke/fire detectors and carbon monoxide alarms. Administrator reports fire/disaster drills are ran on a monthly basis. Fire extinguisher was observed near the kitchen; last inspected March 3, 2026. Backyard provides sufficient space, shady and adequate seating. Pathways free of clutter and obstruction. The facility has two exit doors leading to the backyard. In the garage, the facility maintains their laundry room, emergency supplies, Personal Protective Equipment, cleaning supplies, refrigerators for extra food storage and emergency food and water supply. The garage was observed to be secure inaccessible to residents in care. A hallway closet provided a secure space for the resident's medications and records. Staff files are also maintained securely in the staff area. LPA observed and tested the water temperature and the water tested at 105.3, and 105.0. LPA advised staff to monitor the water temperature. First Aid kits were also observed in this area and complete. Food Service: LPA observed the facility kitchen pantry and refrigerator. The facility's maintains a sufficient amount of non-perishable and perishable food supply for the number of residents in care. Posted food menu listed a variety of options for residents to select from. Facility has a variety of food available for clients. Adequate amounts Dishes, cups, and utensils were also observed in proper storage. Emergency food and water were also observed stored in the attached garage. Sharp objects and cleaning supplies are kept secure and inaccessible to residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. As one of the care staff reside within the facility. Record Reviews: At 3:45 PM, LPA reviewed three (3) out of (3) Staff Files. The files included current Health Screening, Personnel Records, Criminal Records Clearances, Background Statements and Fingerprinting, Annual Training. All staff records we available for review and appears to be maintained. LPA reviewed two (2) out of two (2) resident files for Admission Agreements, Updated Physician Reports, IPP annual report, and Needs and Services Plans. LPA observed that residents file appeared to be maintained. LPA conducted a medication audit and observed that 1 out of 2 residents MARs was missing staff initial stating that medication had been issued for today. A Deficiency cited. Signs: LPA observed the following posters: Infection Control, Long Term Care Ombudsman, Facility License, SEE/SAY Something, Resident Rights, Food Menu, Facility Sketch/Evacuation Plan. LPA observed that the Licensee did not review and update the Emergency Disaster Plan LIC610E. A Technical violation issued. Based on observations, One deficiencies and one technical violation will be cited per Title 22, California Code of Regulations. A copy of this report LIC809, LIC809C, and LIC809D, and appeal rights was read/reviewed with Administrator Lourdes Albao.the state’s words, verbatim · CDSS document, Mar 16, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) LaVette Farlow arrived at the facility unannounced to conduct a Case Management Visit for a health and safety check and to conduct interviews with residents in care. This case management visit is in response to a COMPLAINT #56-AS-20250814152049. LPA was greeted and granted entrance into the facility by Staff, Tessie Martinez. LPA introduced self and stated purpose of the visit. Caregiver Tessie contacted Licensee Rosario and notify her of LPAs arrival. LPA Farlow explained the purpose of the visit. LPA was offer an area to conduct the interview. During today's visit, LPA interviewed residents, and conducted a tour of the facility. LPA did a health and safety check and reviewed documents. No deficiencies were observed during this visit. An exit interview was conducted where this report was reviewed, discussed and then provided to Tessie Martinez, Caregiver.the state’s words, verbatim · CDSS document, Jan 25, 2026

Allegation investigated: Facility has an infestation of Ants Facility has an infestation of Roaches/ Rodent droppings. Facility has mold in the freezer/refrigerator. Boxes are out throughout the facility with clothing and unknown various items.

Licensing Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility to commence a complaint investigation. LPA was greeted and granted entrance by Caregiver, Tessie Martinez. LPA identified herself and discussed the purpose of the visit. LPA ask Caregiver Tessie Martinez, to inform the Administrator Lourdes Albao or the Licensee Rosario Nicolas of my arrival. LPA spoke to Licensee Rosario and she informed me that Caregiver Tessie would assist me and she would call the Administrator Lourdes. During today’s visit, LPA toured the facility, interviewed staff, reviewed and collected documents. The first allegation is: Facility has an infestation of ants. LPA Farlow interviewed S1, S2, and S3 they stated we did have ants but we have a contract with Orkin and they provided service on 8/8/2025. Based on LPA Farlow observation it appears the ant concern is resolved and under control. LPA Farlow did not find evidence to corroborate the allegation. ***Continued in LIC9099C*** Unsubstantiated The second allegation is: Facility has an infestation of Roaches/Rodent droppings. LPA interviewed S1, S2, and S3, and the staff stated they have never seen any roaches in the facility, and the home has never been infested with roaches. Interview with S1, S2, and S3 stated they did see something black on the floor and we cleaned it up, but we have never seen any rodents. S2 and S3 stated we have a contract with Orkin for treatment every 2 months for one year. LPA Farlow did not find evidence to corroborate the allegation. The third allegation is: Facility has mold in the freezer/refrigerator. Based on LPA Farlow observation the freezer/refrigerator was free of mold and all food was labeled. Interview with S2 stated it was blood and not mold. LPA Farlow did not find evidence to corroborate the allegation. The fourth allegation is: Boxes are out throughout the facility with clothing and unknown various items. LPA Farlow conducted a tour of the facility and did not observed boxes left out blocking any pathway or obstructing any walk ways. S2 and S3, stated they have not had any boxes obstructing any pathway making it unsafe for residents in care. Based on LPA Farlow’s interviews, and observation, the allegations are Unsubstantiated. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time. An exit interview was conducted where this report, LIC9099, and LIC9099C, was discussed and provided to Licensee, Rosario Nicolas.the state’s words, verbatim · CDSS document, Aug 19, 2025 · control 56-AS-20250814152049

Type of visit: Required - 1 Year

On 03/20/2025, at 9:30 AM, Licensing Program Analyst, LaVette FArlow, (LPA) arrived at the Sunshine Home II, unannounced to conduct the Annual Inspection. LPA observed caregiver Tessie Martinez outside the home and was greeted by Care Staff, and granted entry. Caregiver Tessie contacted Licensee, Rosario Nicolas to notify of LPA visit. LPA conducted a general overall inspection with care staff, which included, but was not limited to, the following: Physical Plant: At 9:38 AM, LPA conducted a tour of the physical plant the facility is comprised of 3 Resident Rooms, 1 Staff Bedroom, 2 Bathrooms, Kitchen, Dining Room, Living Rooms, Attached Garage, and Backyard. The facility maintains a partnership with the Inland Regional Center at a Level III (3). The facility is approved for six, (6) non-ambulatory, 1 bedridden resident and 1 wheelchair bound resident. LPA was informed the current census at the time of visit was 2. Resident were at their prospective day programs. The facility is operating in the capacity approved by Community Care Licensing (CCL). Pathways inside and outside of the facility were free of obstructions. The facility was maintained at a comfortable temperature 74 degrees Fahrenheit. Resident Rooms were observed orderly and contained all required furnishings such as beds with proper linens, night stands, adequate storage space and lighting. The hallway leading to the bedrooms and bathroom lighting is low. Technical advisory issued. The facility is equipped with functional smoke/fire detectors and carbon monoxide alarms. Administrator reports fire/disaster drills are ran on a monthly basis. Fire extinguisher was observed near the kitchen; last inspected March 2025. Backyard provides sufficient space, shady and adequate seating. Pathways free of clutter and obstruction. At 10:01 AM, LPA observed the screen attached to the sliding glass door leading from the staff office area to the backyard is broken and hanging off the track. LPA Farlow also, observed the exit to the backyard area with the broken screen blocked with boxes and files, obstructing the exit. LPA informed the caregiver of the safety concerns. This poses a safety hazard and a deficiency was cited. The facility has two exit doors leading to the backyard. When Licensee Rosario arrived LPA informed her of the safety concern and the screen was fixed immediately, and licensee stated the boxes will be removed. In the garage, the facility maintains their laundry room, emergency supplies, Personal Protective Equipment, cleaning supplies, refrigerators for extra food storage and emergency food and water supply. The garage was observed to be secure inaccessible to residents in care. A hallway closet provided a secure space for the resident's medications and records. Staff files are also maintained securely in the staff area. LPA observed and tested the water temperature and the water tested at 126.4, 126.3 and 110.8. A technical violation issued. The facility maintain a log documenting a weekly check of the water temperature. The licensee immediately call maintenance to come and adjust the temperature, and place a sign stating caution hot water. First Aid kits were also observed in this area. Food Service: LPA observed the facility kitchen pantry and refrigerator. The facility's amount of non-perishable and perishable food supply was sufficient for the amount of residents in care. Posted food menu listed a variety of options for residents to select from. Facility has a variety of food available for clients. Adequate amounts Dishes, cups, and utensils were also observed in proper storage. Emergency food and water were also observed stored in the attached garage. Sharp objects and cleaning supplies are kept secure and inaccessible to residents in care. Signs: LPA observed the following posters: Infection Control, Long Term Care Ombudsman, Facility License, SEE/SAY Something, Resident Rights, Food Menu, Facility Sketch/Evacuation Plan. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. As one of the care staff reside within the facility. Record Reviews: At 11:00 AM, LPA reviewed three (3) out of (3) Staff Files files which included current Health Screening, Personnel Records, Criminal Records Clearances, Background Statements and Fingerprinting, Annual Training. LPA reviewed two (2) out of two (2) resident files for Admission Agreements, Updated Physician Reports, IPP annual report, and Needs and Services Plans. LPA observed 1 resident IPP plan was missing put the record did include the current quarterly report from IRC. IRC staff completed the IPP annual report and it is documented in resident file. Licensee is waiting for the final report to be provided. Based on observations, One deficiencies will be cited per Title 22, California Code of Regulations, one technical advisory, and one technical violation. A copy of this report LIC809, LIC809C, LIC809D, LIC9102TV, LIC9102TA, and appeal rights was read/reviewed with Licensee Rosario Nicolas.the state’s words, verbatim · CDSS document, Mar 20, 2025

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) LaVette Farlow arrived at the facility unannounced to conduct a Case Management Visit for health and safety and to conduct an interview of one resident in care.This case management visit is in response to a COMPLAINT #56-AS-20241011163624. LPA was greeted and granted entrance into the facility by Staff, Tessie Martinez. LPA introduced self and stated purpose of the visit. The Licensee Rosario was in the facility and greeted LPA and offer an area to conduct the interview. During today's visit, LPA interviewed resident, (R2), staff and conducted a tour of the facility. LPA received requested documents from Licensee. LPA did a health and safety check and reviewed documents. No deficiencies were observed during this visit. An exit interview was conducted where this report was, reviewed, discussed and then provided to Rosario Nicolas, Licensee, and Lourdes Albao, Administrator.the state’s words, verbatim · CDSS document, Jan 23, 2025

Allegation investigated: Staff neglect of resident(s)

Licensed Program Analyst (LPA) LaVette Farlow conducted an unannounced visit to the facility to commence a complaint investigation. LPA was greeted and granted entrance by staff, Tessie Martinez. LPA identified herself and discussed the purpose of the visit. LPA ask that (S1) called and informed the administrator, Rosario Nicolas about the purpose of the visit. During today’s visit, LPA interviewed staff and clients, requested and collected documents. It is alleged that staff neglect of resident(s). Interview with client one (C1) stated that staff treats C1 good and the food is good here. C1 stated that staff (S1) cooks all the time and cleans the facility. C1 stated that staff were informed that C1 can't eat white rice and staff did provide substitute starch for C1. C1 stated she likes living here and her only concern was her roommate talks too much and she can't sleep. C1 stated that sometime she leaves the room and go watch TV in the family room until her roommate goes to sleep. C1 stated that the concern is having a seizure and going to the hospital. Two (2) of the three (3) clients were not in the home and were at the day program. Interview with S1 stated that S1 treats all clients with respect and care. S1 stated that all clients are provided plenty of food and clothing, and she never seen any clients neglected. During the tour of the facility LPA observed the facility has plenty of perishable and non-perishable item in the home for residents in care. Also, the facility has sufficient cleaning, and hygiene items for residents in care. Based on the information above, the allegation is unsubstantiated. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report LIC 9099 and LIC 9099C was discussed, and a copy was provided to Administrator Rosario Nicolas. Unsubstantiated Based on the information above, the allegation is unsubstantiated. A finding of UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. An exit interview was conducted where this report LIC 9099 and LIC 9099C was discussed, and a copy was provided to Administrator Rosario Nicolas.the state’s words, verbatim · CDSS document, Oct 16, 2024 · control 56-AS-20241011163624

Type of visit: Required - 1 Year

Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Sunshine Home II, unannounced to conduct the Annual Inspection. LPA rang the doorbell and was greeted by Care Staff, Fernando Maniclang. Natalia Maniclang, Care Staff also present. Mr. Maniclang contacted Administrator, Lourdes Albao to notify of LPA visit. LPA spoke with Administrator over the phone who reported that she was en route to the facility and LPA could request records from Staff at the facility. LPA conducted a general overall inspection with care staff, which included, but was not limited to, the following: Physical Plant: The facility is comprised of has 3 Resident Rooms, 1 Staff Room, 2 Bathrooms, Kitchen, Dining Room, Living Rooms, Attached Garage, and Backyard. The facility maintains a partnership with the Inland Regional Center at a Level III (3). The facility is approved for six, (6) non-ambulatory, 1 bedridden resident and 1 wheelchair bound resident. LPA was informed the current census at the time of visit was 1. Remaining resident were at their prospective day programs. The facility is operating in the capacity approved by Community Care Licensing (CCL). Pathways inside and outside of the facility were free of obstructions. The facility was maintained at a comfortable temperature. Resident Rooms were observed orderly and contained all required furnishings such as beds with proper linens, night stands, adequate storage space and lighting. The facility is equipped with functional smoke/fire detectors and carbon monoxide alarms. Administrator reports fire/disaster drills are ran on a monthly basis. Fire extinguisher was observed near the kitchen; last inspected March 2023. Backyard provides sufficient space, shady and adequate seating. Pathways free of clutter and obstruction. Garage, the facility maintains their laundry room inside the garage. Also observed were extra Personal Protective Equipment, cleaning supplies, refrigerators for extra food storage and emergency food and water supply. The garage was observed to be secure inaccessible to residents in care. A hallway closet provided a secure space for the resident's medications and records. Staff files are also maintained securely in the staff area. First Aid kits were also observed in this area. Food Service: LPA observed the facility kitchen pantry and refrigerator. The facility's amount of non-perishable and perishable food supply was sufficient for the amount of residents in care. Posted food menu listed a variety of options for residents to select from. Non-perishable and perishable food supply is sufficient for number of clients residing in the facility. Facility has a variety of food available for clients. Adequate amounts Dishes, cups, and utensils were also observed in proper storage. Emergency food and water were also observed stored in the attached garage. Sharp objects and cleaning supplies are kept secure and inaccessible to residents in care. Water temperature was tested and found within required limits. Signs: LPA observed the following posters: Infection Control, Long Term Care Ombudsman, Facility License, SEE/SAY Something, Resident Rights, Food Menu, Facility Sketch/Evacuation Plan. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. As two of the care staff reside within the facility. Record Reviews: Staff Files files included current Health Screening, Personnel Records, Criminal Records Clearences, Background Statements and Fingerprinting, Annual Training. LPA reviewed three resident files for Admission Agreements, Updated Physician Reports, and Needs and Services Plans. Based on observations, no deficiencies will be cited per Title 22, California Code of Regulations. A copy of this report was read/reviewed with Licensee.the state’s words, verbatim · CDSS document, Feb 15, 2024