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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405802274
Report Date: 09/02/2026
Date Signed: 09/02/2026 03:42:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/06/2026 and conducted by Evaluator Garrett Haner-Tomasko
COMPLAINT CONTROL NUMBER: 29-AS-20260806142616
FACILITY NAME:SUNRISE TERRACE RCFE IFACILITY NUMBER:
405802274
ADMINISTRATOR:INGAN, EDWINFACILITY TYPE:
740
ADDRESS:1135 OCEANAIRE DRIVETELEPHONE:
(805) 544-0982
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY:6CENSUS: 6DATE:
09/02/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator - Edwin InganTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Resident is dehydrated due to staff neglect
INVESTIGATION FINDINGS:
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On 9/2/2026 at 9:30am Licensing Program Analyst (LPA) Haner-Tomasko arrived unannounced at the facility to investigate the above allegation to this complaint. LPA met with Administrator Edwin Ingan and explained the purpose of the visit.

During a visit conducted on 8/11/2026 and today’s visit LPA checked the wellbeing of the residents in care and conducted interviews. LPA also conducted the facility annual inspection during today’s visit.

On the allegation, resident is dehydrated due to staff neglect; it was alleged that on a day in August 2026 Resident #1’s (R1’s) urine was observed to be extremely dark in color, indicating extreme dehydration.

(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 29-AS-20260806142616
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: SUNRISE TERRACE RCFE I
FACILITY NUMBER: 405802274
VISIT DATE: 09/02/2026
NARRATIVE
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LPA recently investigated a similar complaint with complaint control #29-AS-20260806142616. During visits to the facility conducted on 7/30/2026, 8/11/2026, and today’s visit LPA observed each resident to have a liquid drink within reach. LPA also observed the facility had multiple drink options including water, a variety of juices, coffee, tea, and soda. R1 stated staff are good about providing them with liquids to drink throughout the day and if they need more they can call them. Residents who are able to communicate, stated that staff bring them something to drink with each meal and if they need more, they can call staff for assistance. Staff stated that they feel they are good about providing residents with something to drink throughout the day and that R1 can be particular about what they like to drink but they ensure they have what R1 likes. They said that they cannot force the residents to drink but they encourage them to drink liquids throughout the day.

Based on all interviews conducted and documents obtained, at this time the above allegation was found to be unsubstantiated, meaning that the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted, report signed, and report provided to the Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Garrett Haner-Tomasko
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2