197603807-1-9-2023-31-AS-NMAN-CMXS7Z-20230110123821

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603807
Report Date: 12/28/2022
Date Signed: 01/09/2023 02:26:54 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, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/30/2021 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20210630101236

FACILITY NAME:	SUNRISE AT STERLING CANYON		FACILITY NUMBER:	197603807
ADMINISTRATOR:	JOHNSON, MICHELLE M		FACILITY TYPE:	740
ADDRESS:	25815 MCBEAN PKWY		TELEPHONE:	(661) 253-3551
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91355
CAPACITY:	140	CENSUS: 127	DATE:	12/28/2022
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Liz Kaplan - Business Office Coordinator		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Facility is understaffed

INVESTIGATION FINDINGS:

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This is an amendment of the report dated 11/02/21 to put additional information on the report.

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit to this facility to investigate further the above allegation. LPA met with Executive Director Tammy Berry and explained the reason for the visit.

LPA conducted physical plant tour at 9:45 AM, requested facility documents relevant to the investigation at 10:05 AM and conducted interviews with residents between 10:30 AM and 1:20 PM. It was alleged that the Facility is understaffed and often the residents are not being checked up on. LPA's interview with fourteen (14) residents or more than 10% of the current census on 08/24/21 between 10:30 AM to 2:00 PM and today between 10:30 AM to 1:20 PM revealed that eleven (11) out of fourteen (14) residents believe that there is sufficient staffing at the facility and they being checked regularly and get sufficient care from the staff.
(continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022

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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Control Number 31-AS-20210630101236

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE AT STERLING CANYON	FACILITY NUMBER: 197603807
	VISIT DATE: 12/28/2022

NARRATIVE

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(continued from LIC 9099)

LPA's interview with staff on 07/01/21 between 10:00 AM and 2:38 PM and 08/24/22 between 10:30 AM to 2:30 PM revealed that eight (8) out of ten (10) staff believed that they have sufficient staff to care for the residents.

Based on the information gathered during this and prior visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022

LIC9099 (FAS) - (06/04)

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