198320179-5-9-2024-11-AS-EMAZ-D5KU98-20240524152243

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320179
Report Date: 05/09/2024
Date Signed: 05/09/2024 04:38:57 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2024 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 11-AS-20240503093132

FACILITY NAME:	SUNRISE OF BEVERLY HILLS		FACILITY NUMBER:	198320179
ADMINISTRATOR:	RITA MELDONIAN		FACILITY TYPE:	740
ADDRESS:	201 NORTH CRESCENT DRIVE		TELEPHONE:	(310) 274-4479
CITY:	BEVERLY HILLS	STATE: CA	ZIP CODE:	90210
CAPACITY:	127	CENSUS: 70	DATE:	05/09/2024
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Liza Bond		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff do not ensure that resident's medical condition is properly managed.
Staff do not assist resident with hygiene needs.
Staff do not ensure that resident's dietary needs are met.

INVESTIGATION FINDINGS:

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On 05/09/2024, Licensing Program Analyst (LPA) Antonine Richard conducted a complaint visit to deliver findings regarding the above allegations. LPA Richard met with Resident Care Director Liza Bond. Later was joined with Administrator Hawell Zachary and Assisted Living Coordinator Nancy Maya.

The investigation consisted of the following:
On 05/09/2024, LPA Richard toured the facility. LPA Richard reviewed and requested, staff and resident's records, LIC 602, and the daily assignment sheets, Physician Report, Resident Scheduled menu. LPA requested copies of supporting documents. LPA interviewed five (R1-R5) Residents, and five staff (S1-S5). LPA Richard requested and copies of supporting documents. Reviewed and collected facility documents.

This report is continued, please see LIC9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 11-AS-20240503093132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SUNRISE OF BEVERLY HILLS	FACILITY NUMBER: 198320179
	VISIT DATE: 05/09/2024

NARRATIVE

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Allegation 1: Staff do not ensure that residents’ medical condition is properly managed.

It is alleged that staff do not ensure that a resident’s medical condition is properly managed resulting in the resident was admitted to the hospital due to a blood sugar of 40.
The investigation revealed that on 05/09/24, LPA Richard interviewed the Resident Care Director Liza Bond, (RCD) regarding the above allegation, the (RCD) denied the allegation above. The (RCD) stated that, blood sugars are checked according to the Doctors orders, and can be checked from 1 time a day to 2 times a day. The (RCD) stated that R1 was diagnosed with type 2 diabetes at the time of admission. LPA reviewed and obtained resident R1’s physician’s medication management dated from 10/05/23 to 04/15/24, and there was no instruction about having R1 blood sugar checked. On 04/15/24, R1 physician increase R1 medication without any mentioned of any new order of needing to check the blood sugar. LPA interviewed five staff (S1-S5) regarding the above allegation, 3 out of 5 staff interviewed did not assist with medication administration, 1 of the 5 staff interviewed denied the above allegation. Staff S1 interviewed, stated that blood sugars are checked and documented daily according to doctors’ orders. On 05/09/24 LPA interviewed with residents (R2-R6) regarding the above allegation, 2 out of 5 residents interviewed were unable to provide information regarding allegation above, 3 out of 5 residents interviewed reported the facility do not conducted any blood sugar for them. Records reviewed during the investigation showed that LPA did not find sufficient evidence to support the allegation that staff do not ensure resident's medical condition is properly managed.

Continued LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20240503093132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SUNRISE OF BEVERLY HILLS	FACILITY NUMBER: 198320179
	VISIT DATE: 05/09/2024

NARRATIVE

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Based on interviews there is not sufficient evidence to support the allegation that Staff do not ensure that a resident's medical condition is properly managed. 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.

Regarding the allegation 2: Staff do not assist resident with hygiene needs.

It is alleged that staff do not assist resident with hygiene needs resulting in “resident appeared dirty, not being clean and greasy”.

The investigation revealed that the facility provides showering assistance to resident in care. Records reviews indicate that there is a resident shower schedule and notes indicating if client refused or accepted to take a shower. During interviews with the staff (S1-S5), 5 out of 5 stated that the residents shower regularly. The staff stated that resident R1 constantly refused their help. All the staff stated that R1 wakes up early, around 6:00 am, and wears the same clothing as the day before. When staff tried to help and change the clothing, R1 refused. LPA interviewed five residents (R2- R6), 4 out of 5 indicated that they did not need assistance with hygiene and shower. Only 1 out of 5 residents stated that the staff helped with showering and dressing. R2, R5, R4 and R6 stated they do not require assistance with showering, brushing their teeth, and getting dressed. LPA reviewed the resident R1 Needs of service plan. R1 are scheduled to shower two times a week. LPA reviewed the shower scheduled from 04/10/24 to 04/27/24. The schedule showed R1 was scheduled and was assisted with taking a shower. LPA Richard reviewed the residents shower schedule for the month of March 2024, and observed that all residents have received their scheduled shower.

Continued LIC9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20240503093132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SUNRISE OF BEVERLY HILLS	FACILITY NUMBER: 198320179
	VISIT DATE: 05/09/2024

NARRATIVE

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Resident R3 stated that the staff does assist with grooming and bathing and that they are happy with the care and supervision given. Sometimes the staff provide verbal assistance on how to proper brushed teeth and comb their hair. LPA could not interview R1 because R1 was out of the facility. Based on the information gathered, interviewed and records reviewed, LPA did not find sufficient evidence to support the allegation staff did not assist resident with hygiene needs.

Based on interviews, and records reviewed there is not sufficient evidence to support the allegation that Staff did not assist resident with hygiene. 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.

Regarding the allegation 3: Staff do not ensure that resident’s dietary needs are met.

It is alleged that the staff do not ensure that resident’s dietary needs are met, resulting of resident missing meals.
The investigation revealed that the facility served three meals per day to the residents in care. Records reviews showed the facility have a special diet menu for the resident who doctor’s order special meals. LPA interviewed five residents (R2-R6) and five staff (S1-S5), regarding the allegation. During the interviews with five residents (R2-R6) 5 out of 5 stated they are served three meals daily plus snacks. Residents (R2- R6) stated they are not on a special diet and have no issues with getting their meals. LPA interviewed five staff (S1-S5), and 4 out of 5 stated that three meals are prepared and served to all residents daily.

Continued LIC9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20240503093132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: SUNRISE OF BEVERLY HILLS	FACILITY NUMBER: 198320179
	VISIT DATE: 05/09/2024

NARRATIVE

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The staff (S1, S3, S4) stated that two snacks were offered daily for every resident. Staff (S2-S5) stated the kitchen prepares special diet foods for diabetes clients with the physician orders. Staff (S2) stated there is a menu of residents with special diet needs that are met with each meal. LPA reviewed and obtained menu various meal. LPA reviewed physician’s orders from 10/05/23, to 04/15/24; and there was no instruction about having R1 on a special dietary menu. LPA reviewed resident R1’s scheduled meals from 04/10/24 to 04/29/24 before R1 went to the hospital on 04/30/24, the resident R1 was provided breakfast, lunch, and dinner. All the staff and residents stated if a resident is on a special diet staff is following their physician's orders. Residents and staff stated the facility is providing proper food service. The residents who were interviewed were content with the food that has been served to them. The menus are written at least five weeks in advance and copies of the menus are posted in the facility dining room, activity room and copies are also, kept on file. The staff stated they also have daily menu. During the investigation, LPA did not find sufficient evidence to support the allegation staff do not ensure resident’s dietary needs are met.

Based on LPA observation, interviews conducted and records reviews, 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 violations did or did not occur, therefore the allegation is Unsubstantiated.

No deficiencies cited. Exit interview conducted and a copy of this report was provided to the Assisted Living Coordinator Nancy Maya.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024

LIC9099 (FAS) - (06/04)

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