198320179-3-30-2022-11-AS-AJKK-CDMVP5-20220419163606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320179
Report Date: 03/30/2022
Date Signed: 03/30/2022 01:57:58 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, 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
07/27/2021 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210727141047

FACILITY NAME:	SUNRISE OF BEVERLY HILLS		FACILITY NUMBER:	198320179
ADMINISTRATOR:	MALONE, JASON		FACILITY TYPE:	740
ADDRESS:	201 NORTH CRESCENT DRIVE		TELEPHONE:	(310) 274-4479
CITY:	BEVERLY HILLS	STATE: CA	ZIP CODE:	90210
CAPACITY:	127	CENSUS: 66	DATE:	03/30/2022
		UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:	Executive Director, Jason Malone		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Resident received unexplained bruises while in care

INVESTIGATION FINDINGS:

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On 03/30/2022, Licensing Program Analyst (LPA) Troy Agard conducted a subsequent complaint investigation at the above facility to address the following allegation. LPA Agard was met with Executive Director, Jason Malone and explained the purpose of the visit was to gather information regarding this complaint.

LPA requested copies of the following documents: Resident roster, Staff Roster, Medication Administration Records, Resident’s Needs and Service Plan, progress notes and Physicians Report.

The investigation consisted of the following: LPA Agard toured the facility, conducted interviews with staff, residents, and reviewed records.

On 03/30/2022 LPA Agard delivered findings:

cont. on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

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 11-AS-20210727141047

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUNRISE OF BEVERLY HILLS	FACILITY NUMBER: 198320179
	VISIT DATE: 03/30/2022

NARRATIVE

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Regarding the allegation: Resident received unexplained bruises while in care. It’s being alleged that a resident sustained bruising while in care. The investigation revealed the following: During interviews with the staff, 4 out of 4 denied the allegation to be true. S1 denies the allegation occurred at the facility. “R1 was sent to UCLA psych. Eventually, the hospital was able to stabilize them. The family was extremely satisfied with our services. We were surprised by the complaint because even the family stated the bruising came from the hospital visit.” S2 states, I spent a lot of time as R1’s 1 to 1. We are trained to sooth residents when they are in crisis. We are trained to back away. We don’t do restraints here.” S3 states, “never witness anyone grabbing or restraining R1. If I did, I would have definitely reported that. We have to report any little thing here.”

During interviews with the residents the following was revealed: 4 out of 5 residents denied the allegation to be true. 1 resident was unavailable for an interview. R2-5 unanimously all agreed that they enjoy living at the facility, denies ever being mistreated, restrained or handled in a way that may cause injury. R2 states, “well I like it very much obviously. I’ve been here almost 8 years. The staff treat me well, oh my God yes. If there is anything I can say I really love it here.” R4 states, “I’ve been here 10.5 years. I enjoy it. They are all my angels. They help me whenever I need it. The staff, they are all very kind to me. I think it’s a wonderful place.” During an interview with W1 they state, “I never had any concerns about Sunrise. They took really good care of my relative. I have no particular case against Sunrise. They took really good care of R1. The bruises came from the hospital restraining R1 during their time there.”

During a review of the medication administration record, LPA observed resident was on a medication that made bruising easier and may have taken longer than usual for any bleeding to stop. During a review of progress notes there was no indication of bruising prior to resident leaving for the hospital. When resident returned back to the facility it was noted that resident had a small bruise on right arm with skin intact.

Based on LPA’s observation, interviews conducted, and record review, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of the report was given.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

LIC9099 (FAS) - (06/04)

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