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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198602944
Report Date: 10/06/2026
Date Signed: 10/06/2026 01:16:34 PM

Document Has Been Signed on 10/06/2026 01:16 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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME:BRIGHT SUNLIFE GUEST HOMEFACILITY NUMBER:
198602944
ADMINISTRATOR/
DIRECTOR:		MORALES, MARIOFACILITY TYPE:
740
ADDRESS:22633 VAN DEENE AVETELEPHONE:
(424) 558-8761
CITY:TORRANCESTATE: CAZIP CODE:
90502
CAPACITY: 6CENSUS: 5DATE:
10/06/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:38 AM
MET WITH:Algel Culala - CaregiverTIME VISIT/
INSPECTION COMPLETED:
01:39 PM
NARRATIVE
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On 10/06/2026 at 08:38AM, Licensing Program Analyst (LPA) Mario Leon conducted an unannounced annual inspection visit at the Facility. California Department of Social Services (CDSS) was allowed entry into the facility by Staff one, Algel Culala (S1). The facility is licensed to serve (6) residents aged 60 and above of which four (4) non-ambulatory, two (2) bedridden. Facility has an approved hospice waiver for four (4) residents. Currently the facility has (5) residents.
As part of the inspection, CDSS reviewed: five (5) resident service records, five (5) resident client medication records (MAR), three (3) staff records, and inspected the inside facility and outside grounds. The facilities’ last fire drill was conducted on 09/15/2026. The facility is a one (1) story residential home, located in a residential neighborhood, which consists of five (5) resident bedrooms, two (2) resident bathrooms, living room, dining room, kitchen with washer and dryer/storage area, office area, attached garage, and backyard. Although the washer and dryer are in working condition, according to S1, the owner of the facility prefers to wash resident's clothing at Laundromat. No weapons are stored on the premises. Kitchen was inspected and observed to be clean and operational, though residents do not use. Kitchen water temperature was measured at 122.7°F (degrees Fahrenheit) in the kitchen, though not above 125°F, please see LIC9102-TA. CDSS observed a two-day supply of perishable food and seven-day supply of non-perishable foods are present in the facility. Emergency Water Storage is in the garage and kitchen area.
CDSS observed that all facility rooms are clean and in good repair. A comfortable temperature of 77.1°F was measured, and the facility has central air and heating. CDSS 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, CDSS observed fully stocked closet with bedding, towels, and toiletries supplies. Report continues, please see LIC809-C.
Ulysses Coronel
Mario Leon
DATE: 10/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2026
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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: BRIGHT SUNLIFE GUEST HOME
FACILITY NUMBER: 198602944
VISIT DATE: 10/06/2026
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Bathroom fixtures are clean, in good repair, and working properly and contain the required nonskid mats and grab bars. CDSS observed bathrooms were found to be within Title 22 regulation. Bathroom #1 hot water temperature properly measured at 117.2°Ft, and bathroom #2 hot water temperature properly measured at 115 degrees Fahrenheit. Facility (1) Carbon Monoxide and (7) Smoke Detectors, hardwired and connected, were tested and are working properly. The facility two (2) Fire Extinguishers were checked and found to be fully charged and accessible, last maintained on 08/06/26. All exit doors in the facility have alarm systems. The facility has a working land line telephone. All toxins and knives are locked/secured and inaccessible to clients. Medications are centrally stored and in a locked storage cabinet. Facility's first aid kit is fully stocked with manuals, 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) resident files were reviewed and found to be complete. CDSS 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 two (2) have the required documents. Staff three, Heidi Skiles - Administrator (S3), license (#6054123740) was observed to be expired as of 11/03/2023. Although S3 claims to have completed appropriate training, CDSS was not able to locate S3 within Active/Pending Initial/Pending Renewals. Please see LIC809-D. Commercial General Liability Policy #00167520-0 policy period, from 11/28/2025 to 11/28/2026, underwritten by Perlas Insurance Services with 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), CDSS observed one (1) deficiency. Annual Licensing Fee is current, last paid on 09/08/26.

There has been one (1) deficiency cited, please see LIC809-D. One Technical Advisory was provided, please see LIC9102-TA.

An exit interview was conducted, and a copy of the Facility Evaluation Report, one (1) deficiency, one (1) technical advisory, facilities' appeal rights were provided to Staff one, Angel Culala.

NAME OF LICENSING PROGRAM MANAGER: Ulysses Coronel
NAME OF LICENSING PROGRAM ANALYST: Mario Leon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/06/2026 01:16 PM - It Cannot Be Edited


Created By: Mario Leon On 10/06/2026 at 12:59 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: BRIGHT SUNLIFE GUEST HOME
FACILITY NUMBER: 198602944

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87412(d)
Personnel Records
(d) The licensee shall maintain documentation that an administrator has met the certification requirements specified in Section 87406, Administrator Certification Requirements or the recertification requirements in Section 87407, Administrator Recertification Requirements.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(record review)], the licensee did not comply with the section cited above in [one] out of [one] [administration certificate] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/27/2026
Plan of Correction
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Staff one and LPA have agreed that administrator will submit proof of completion on or prior to POC due date, via email, at MARIO.LEON@DSS.CA.GOV
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ulysses Coronel
NAME OF LICENSING PROGRAM MANAGER:
Mario Leon
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2026


LIC809 (FAS) - (06/04)
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