019200722-9-20-2022-15-AS-KHOS-CKLLRF-20221027085903

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200722
Report Date: 09/20/2022
Date Signed: 09/20/2022 01:57:33 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
07/19/2022 and conducted by Evaluator Kelly Nguyen

COMPLAINT CONTROL NUMBER: 15-AS-20220719123026

FACILITY NAME:	SUNRISE OF PLEASANTON		FACILITY NUMBER:	019200722
ADMINISTRATOR:	TRACY BURKE		FACILITY TYPE:	740
ADDRESS:	5700 PLEASANT HILL RD		TELEPHONE:	(925) 416-0238
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94588
CAPACITY:	103	CENSUS: 80	DATE:	09/20/2022
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Tracy Burke, Executive Director		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Facility is not following proper COVID-19 testing guidance

INVESTIGATION FINDINGS:

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On 09/20/22 at 10:50 am, Licensing Program Analysts (LPAs) K. Nguyen and L. Francisco to deliver findings for the above allegation and met with Tracy Burke, Executive Director.

During the course of the investigation, LPA K. Nguyen obtained information, collected documents, interviewed staff and residents. Based on record reviews and interviews, facility is following COVID-19 testing guild line as instructed by Alameda County Public Health. Facility is following proper COVID- 19 infection control as indicated in their COVID-19 Mitigation plan submitted on 08/15/2022. On 7/21/22 LPA observed that facility was in the process of conducting mass testing for resident and staff. LPA received daily reports of residents and staff that tested positive, and facility is in communication with Alameda County Public Health.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED. Exit Interview conducted and a copy of this report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bennett Fong	TELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Kelly Nguyen	TELEPHONE: (510) 915-8702
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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