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Source: VA State Licensing Agency
Type of inspection: Monitoring Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 03/03/2026 from 11:45 am until 12:30 pm. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of residents present at the facility at the beginning of the inspection: 0 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of resident records reviewed: 0 Number of staff records reviewed:1 Number of interviews conducted with residents:0 Number of interviews conducted with staff: 1 Observations by licensing inspector: Review of Staff record, observation of the Facility, water temperature check and Emergency Preparedness occurred during this onsite visit. Additional Comments/Discussion: An exit meeting will be conducted to review the inspection findings. The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Your plan of correction must contain: 1) steps to correct the noncompliance with the standard(s), 2) measures to prevent the noncompliance from occurring again; and 3) person(s) responsible for implementing each step and/or monitoring any preventive measure(s). Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of these inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Refer to General Procedures and Information for Licensure, 22VAC40-80-260-B for information on requesting a problem solving conference. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lanesha Allen, Licensing Inspector at 757-715-1499 or by email at Lanesha.allen@dss.virginia.gov .
Based on the onsite observation conducted 03/03/2026, the facility did not ensure to maintain All furnishings, fixtures, and equipment, including furniture, window coverings, sinks, toilets, bathtubs, and showers be kept clean and in good repair and condition. Evidence: 1. During the onsite inspection on 03/03/2026, Bedroom A, Bathroom A shower was observed not clean during onsite inspection. 2. During the onsite inspection on 03/03/2026, Bathroom B shower was observed not clean during onsite inspection. 3. During the onsite inspection on 03/03/2026, the hallway door was off the hinges and leaned on wall during onsite inspection. 4. During the onsite inspection on 03/03/2026, the kitchen area to include sink, cabinets and ceiling were observed not clean during onsite inspection. 5. Staff #1 acknowledged the observations of the Licensing Inspector during the onsite inspection on 03/03/2026.
Type of inspection: Initial Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 9/22/2025 from 10:07 am to 11:00 am. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. Number of participants present at the facility at the beginning of the inspection: 0 The licensing inspector completed a tour of the physical plant that included the building and grounds of the facility. Number of participant records reviewed:0 Number of staff records reviewed:3 Number of interviews conducted with participants:0 Number of interviews conducted with staff: 2 Observations by licensing inspector: Tour of Buildings and Grounds The evidence gathered during the inspection determined non-compliance with applicable standard(s) or law, and violation(s) were documented on the violation notice issued to the facility. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Lanesha Allen, Licensing Inspector at 757-715-1499 or by email at Lanesha.allen@dss.virginia.gov
Based on onsite observation, the facility did not ensure the kit shall include the following items: Blankets, either disposable or other, Disposable single-use breathing barriers or shields for use with rescue breathing or CPR, Small flashlight and extra batteries, Triangular bandages. Evidence: 1. During the onsite inspection on 9/22/2025, a review of the first aid kit identified the following missing items: Blankets, either disposable or other, Disposable single-use breathing barriers or shields for use with rescue breathing or CPR, Small flashlight and extra batteries, Triangular bandages. 2. Staff #1 confirmed the items were not present during the onsite inspection.
Based on onsite observation, the facility did not ensure Bathrooms equipped to accommodate more than one person at a time shall be labeled by gender. Gender designation of bathrooms shall remain constant during the day. Evidence: 1. During the tour of the facility on 9/22/2025, Bathroom 1, which is located in the hallway of the facility was not labeled by gender. 2. Staff #1 acknowledged the bathrooms were not labeled by gender.
Based on onsite observation, the facility did not ensure the interior and exterior of all buildings shall be maintained in good repair and kept clean and free of rubbish. Evidence: 1. During the tour of the facility on 9/22/2025, areas in the interior of the home required cleaning, the ceiling had brown staining in the kitchen area, dining and bedroom window seals had chipped painting, outdoor window wood hung from widow frame. 2. Staff #1 confirms during the onsite the identified areas that required repair and cleaning.
Based on the onsite observation conducted 9/22/2025, the facility did not ensure to maintain liability insurance coverage according to the following licensed capacity tiers: 1. Tier I: A minimum of $250,000 for facilities licensed for 25 residents or fewer; Evidence: 1. During the onsite inspection on 9/22/2025, Staff #1 did not have liability coverage as required by regulation. 2. Staff #1 acknowledges he did not have liability insurance at the time of inspection on 9/22/25.
Based on onsite observation, the facility did not ensure Bedrooms shall contain the following items: a separate bed, a table, an operable bed lamp, a sturdy chair, a mirror. Evidence: 1. During the onsite inspection on 9/22/2025, Bedroom A it did not consist of the following: A Table accessible to each bed, A Bed lamp or bed light, A sturdy chair. 2. During the onsite inspection on 9/22/2025, Bedroom B it did not consist of the following: a separate bed, a table, an operable bed lamp, a sturdy chair, a mirror. 3. During the onsite inspection on 9/22/2025, Bedroom C did not consist of the following: a table, blinds, a mirror. 4. During the onsite inspection on 9/22/2025, Bedroom D did not consist of the following: a table, a mirror. 5. Staff #1 acknowledge the items were not present during the onsite inspection for Bedroom A, Bedroom B, Bedroom C, Bedroom D.
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