Facility Evaluation Report

04/07/2026, Licensing Program Analyst (LPA) Loera arrived unannounced to conducted a Case Management - Legal/Non-compliance Inspection. Upon arrival, LPA was greeted by an individual (I1) who stated they do not work at the facility. The individual stated the administrator and other staff member had left and they were called to cover the facility during their absence.

LPA contacted facility Administrator via phone and notified them they were at the facility and had sent the individual home as they were not background cleared and associated to the facility. (*Civil Penalty being assessed in the amount of $500) Administrator, Leslie Wilson arrived at approximately 4:30pm.

This facility was placed on non-compliance on July 23rd, 2025 for a two-year term.

LPA went over compliance plan and reminded facility of the below agreement of 07/23/2025 between Community Care Licensing (CCL) and Facility, Sundance Villa Inc:

- Facility failed to provide adequate care resulting in hospitalization of a resident due to pressure wounds

- Administrator Qualifications and Duties

Deficiencies are cited from the California Code of Regulations (CCRs), and/or the Health and Safety Code. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in additional civil penalties.

Copy of report, appeal rights, LIC421IM and confidential names form were provided.