015600562-5-31-2024-15-AS-BFOG-D66U4K-20240612151516

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 015600562
Report Date: 05/31/2024
Date Signed: 05/31/2024 03:49:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2022 and conducted by Evaluator Alicia Delmundo

COMPLAINT CONTROL NUMBER: 15-AS-20220214110352

FACILITY NAME:	MORNING SUN CARE HOME		FACILITY NUMBER:	015600562
ADMINISTRATOR:	GALANG, ROSARIO		FACILITY TYPE:	735
ADDRESS:	1502 171ST STREET		TELEPHONE:	(510) 481-9708
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	6	CENSUS: 6	DATE:	05/31/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Maria Theresa 'Tek' Ordiniza/Assistant Administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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-Staff prevent resident from interacting with family.

-Resident prohibited from going out of the home to go on outings.

-Resident prohibited from using the phone.

INVESTIGATION FINDINGS:

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On this day, May 31, 2024, Licensing Program Analyst (LPA) Delmundo arrived unannounced to deliver the findings for the above allegations and close the complaint. LPA met with Maria Theresa 'Tek' Ordiniza, assistant ddministrator , and informed the reason for visit.

During the course of investigation, LPA obtained copies of LIC9020 Register of Facility Clients/Residents, reviewed files and obtained copies of resident (R1) LIC602 Physician’s Report, Individual Service Plan (ISP), Individual Program Plan (IPP) and LIC625 Appraisal/Needs and Services Plan.

LPA interviewed staff on 2/22/22, 12/23/22, and 5/28/24 and administrator on 5/21/24. The residents were interviewed on 3/29/22 and 12/23/22, and R1’s family member (FM) on 7/26/23. LPA also interviewed R1’s case manager (CM) on 12/22/22.

....continued on 9099C (page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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 3

Control Number 15-AS-20220214110352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: MORNING SUN CARE HOME	FACILITY NUMBER: 015600562
	VISIT DATE: 05/31/2024

NARRATIVE

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Page 2

Allegation: Staff prevent resident from interacting with family.
It was alleged that the facility did not provide FM’s phone number for resident (R1) to talk to the family. The 3 staff and administrator stated they didn’t prohibit R1 from interacting with his family. One of the staff stated when FM provided FM’s contact number to her, she had mis-written one of the numbers, however, when FM called the facility, staff gave the phone to R1. FM stated she was not informed that staff incorrectly wrote her telephone number. R1 stated FM called him when he was at the facility.

Allegation: Resident prohibited from going out of the home to go on outings.
It was alleged that R1 was not allowed to go out of the facility with FM, go out on outings or go to church. Reporting party (RP) stated that FM indicated that the staff told FM that if FM takes R1 out, R1 can not go back to the facility.

The administrator and 3 staff interviewed denied the allegation. All staff stated R1 was allowed to go out for an outing and go to church every Sunday. FM stated she’s able to take R1 to eat out and went shopping and that R1 was allowed to go to church. All 5 residents including R1 stated they were allowed to go out. Due to medical diagnosis, LPA was not able to obtain information from one of the residents. CM stated he does know if it's about COVID that R1 is being prohibited from going out, but he didn't hear anything about R1 being prohibited from going out and that R1 goes to church.

....continued on 9099C(page 3)

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 15-AS-20220214110352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: MORNING SUN CARE HOME	FACILITY NUMBER: 015600562
	VISIT DATE: 05/31/2024

NARRATIVE

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Page 3

Allegation: Resident prohibited from using the phone.
RP stated FM informed RP that the facility was not allowing R1 to use the phone. LPA interviewed 3 staff and administrator who stated the residents were not prohibited from using the facility telephone. All 5 residents including R1 stated they were allowed to use the telephone. Due to medical diagnosis, LPA was not able to obtain information from one of the residents. FM stated she’s not able to speak with R1 when she called the facility; however, FM stated when she’s talking to R1 on the phone, staff listened, but the staff denied this allegation. R1 stated when he talked to FM, the staff gives the phone to him, and he hold the phone himself and staff leaves his room.

Based on all information gathered and due to LPA unable to obtain information from one of the residents, all 3 allegations are closed as unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

No deficiency cited.

Exit interview conducted and copy of this report provided.

SUPERVISORS NAME: Bennett Fong
LICENSING EVALUATOR NAME: Alicia Delmundo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3