197608842-6-18-2026-11-AS-EMAZ-DXASJH-20260825135511

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608842
Report Date: 06/18/2026
Date Signed: 06/18/2026 02:08:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/11/2026 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 11-AS-20260611163254

FACILITY NAME:	SUNNY HILLS ASSISTED LIVING (MEMORY CARE)		FACILITY NUMBER:	197608842
ADMINISTRATOR:	SUNGNAM PARK "SUSAN"		FACILITY TYPE:	740
ADDRESS:	8717 WEST OLYMPIC BLVD.		TELEPHONE:	(310) 659-4301
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	120; 120	CENSUS: 71	DATE:	06/18/2026
		UNANNOUNCED	TIME BEGAN:	08:43 AM
MET WITH:	Jung Hee Kim		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff leave resident in soiled diaper for an extended period.

INVESTIGATION FINDINGS:

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On 06/18/2026, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Jung Hee Kim, Executive Director, and the purpose of today’s visit was explained. LPA was granted entry into the facility.

The investigation consisted of:
During today's visit, LPA inspected the facility, interviewed Staff S1-S5, interviewed Residents R1-R7, and received and reviewed documents pertinent to the investigation. The following documents were received and reviewed Staff Roster, Resident Roster, Admission Agreement (dated 04/30/2025), Identification and Emergency Information (dated 04/30/2025), Physician’s Report (dated 07/16,2025), Needs and Service Plan (dated 01/27/2026), Physician’s Orders, and In-Service Logs (from 07/16/2025 through 06/17/2026).

The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026

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 11-AS-20260611163254

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUNNY HILLS ASSISTED LIVING (MEMORY CARE)	FACILITY NUMBER: 197608842
	VISIT DATE: 06/18/2026

NARRATIVE

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Allegation: Staff leave resident in soiled diaper for an extended period
The allegation alleges that staff do not regularly change a resident’s diaper knowing the resident requires frequent changes.

During the facility inspection, LPA observed a list of residents who require assistance with incontinent care posted behind the front desk. LPA observed caregivers taking residents to the restroom or checking to see if they need changed.

During Record Review, LPA received and reviewed Staff In-Service Training logs regarding residents Personal Rights. S1 stated incontinent care is part of the of the staff Personal Rights Training. LPA received and reviewed training material for incontinent care.
During interviews with Staff S1-S5, were asked how often residents are assisted with changing diapers or using the restroom, five (5) out of five (5) stated residents are checked every 2 hours to see if they need changed or use the restroom and they are cleaned and changed every four (4) hours.
During interviews with Residents R1-R7, were asked if they have been left in soiled diapers for an extended period of time, four (4) out of seven (7) stated they have not been left in soiled diapers for an extended period of time. One (1) out of seven (7) shook their head yes, when asked if they were left in a diaper for an extended period of time. Two (2) out of seven (7) declined to be interviewed.
During interviews with Residents Responsible Party’s W2, was asked if there was a time they have come to the facility and observed their resident in soiled diapers, W2 stated no, they have not observed that. Additionally, W2 was asked if they have any concerns regarding residents being left in soiled diapers, W2 stated no, they have no concerns.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

LPA did not observe or cite any deficiencies.

An exit interview was conducted with Jung Hee Kim, Executive Director, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2026

LIC9099 (FAS) - (06/04)

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