019200755-9-25-2023-15-AS-KHOS-D3AQ4F-20240312115015

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 019200755
Report Date: 09/25/2023
Date Signed: 09/25/2023 02:56:18 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
01/10/2023 and conducted by Evaluator Kelly Nguyen

COMPLAINT CONTROL NUMBER: 15-AS-20230110115922

FACILITY NAME:	SUNRISE ASSISTED LIVING OF OAKLAND HILLS		FACILITY NUMBER:	019200755
ADMINISTRATOR:	CAGULADA, DILLON R		FACILITY TYPE:	740
ADDRESS:	11889 SKYLINE BLVD		TELEPHONE:	(510) 531-7190
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94619
CAPACITY:	100	CENSUS: 77	DATE:	09/25/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Deborah Savoie, Executive Director		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Staff do not properly dispose of residents' soiled linens
Staff are not properly trained

INVESTIGATION FINDINGS:

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On this day, 9/25/2023 at 2:00PM Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to deliver the finding on the above allegations. LPA met with Deborah Savoie, Executive Director and explained the purpose of the visit.

Allegation: Staff do not properly dispose of residents' soiled linens: Unsubstantiated
It was alleged that Staff do not properly dispose of residents' soiled linens. LPA interviewed 5 care staff. 5 out of 5 states that “We all have our training course, and we know that it’s our job to wrap the resident soiled linen up. We never leave it without wrapping it up”.

Allegation: Staff are not properly trained: Unsubstantiated.
It was alleged that Staff are not properly trained. LPA interviewed RP and RP stated that RP wasn’t sure if all staff have proper training. LPA sample 5 staff training records 5 out of 5 staff training recorded have 100 percent completion on all training courses.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not 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: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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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