197607506-9-11-2021-31-AS-NMAN-C7CVFY-20210930162444

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607506
Report Date: 09/11/2021
Date Signed: 09/11/2021 02:35:47 PM

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
06/14/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20210614160301

FACILITY NAME:	SUNSHINE'S PLACE II		FACILITY NUMBER:	197607506
ADMINISTRATOR:	ROSARIO SORIANO		FACILITY TYPE:	740
ADDRESS:	7328 QUARTZ AVE.		TELEPHONE:	(818) 739-0492
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91306
CAPACITY:	6	CENSUS: 5	DATE:	09/11/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Carlo Fuentes		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Client is being physically abused while in care
Client is not being provided appropriate care and supervision while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent complaint visit to finish investigation into the allegations above. LPA met with facility staff and explained the reason for this visit.
LPA spoke with the administrator over the telephone regarding the reason for this visit.

Regarding the allegations above it is alleged that resident # 1 (R1) was being physically abused while in care and that R1 was not being provided the appropriate care and supervision while in care. LPA conducted a previous visit on 6/15/21 to investigate these allegations. LPA attempted to speak with R1's responsible person on multiple occassions and has left several messages. LPA had previously conducted an interview with the administrator and obtained copies of R1's physician report, assessment, and incident reports regarding R1. Information obtained from an interview with the administrator reveal that R1 went to the doctor on 5/25/21 due to having abdominal pain and couldn't use the bathroom properly and some test were ran. R1 was discharged back to the facility the same day. On 6/4/21 R1 went back to the hospital for the same reason.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2021

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-20210614160301

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: SUNSHINE'S PLACE II	FACILITY NUMBER: 197607506
	VISIT DATE: 09/11/2021

NARRATIVE

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It was found that R1 had kidney stones and Urinary Tract Infection (UTI). The day before R1 went to the hospital, R1 had a bowel movement on thyself after not having one for a few days. Facility staff decided to keep R1's underwear off in anticipation of another bowel movement when R1's responsible person came to the facility. R1's responsible person was upset that R1 did not have any underwear on and thought it was a form of neglect. On 6/4/21 after going to the hospital again R1 never returned to the facility at the decision of R1's responsible person. On 6/15/21 LPA spoke to the staff from Kaiser who stated they did not observe any signs of abuse or neglect. During today's visit LPA interviewed one resident out of five regarding the complaint allegation. Four out of the five residents were not able to understand what was being asked due to their medical diagnosis. Based on the information obtained through interviews and documents reviewed this allegation is deemed Unsubstantiated at this time. LPA has not been able to interview R1 or R1's responsible person. Exit Interview conducted.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2021

LIC9099 (FAS) - (06/04)

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