198602615-11-17-2023-28-AS-RORN-CY9MWT-20231206085851

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602615
Report Date: 11/17/2023
Date Signed: 11/17/2023 11:29:06 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/06/2023 and conducted by Evaluator Erik Zaragoza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231106153525

FACILITY NAME:	SUNSHINE RESIDENTIAL HOME		FACILITY NUMBER:	198602615
ADMINISTRATOR:	JOSE, OYINLOYE AUSTINE		FACILITY TYPE:	735
ADDRESS:	1159 E 68TH ST		TELEPHONE:	(323) 305-3552
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90001
CAPACITY:	4	CENSUS: 4	DATE:	11/17/2023
		UNANNOUNCED	TIME BEGAN:	10:24 AM
MET WITH:	Preciuos Brown - House Manager		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Client was physically attacked while in care
Staff did not seek timely medical attention for a client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Erik Zaragoza conducted a follow up complaint investigation regarding the allegations listed above. LPA met with Gil Martinez Assistant Administrator / DSP and explained the reason for the visit. Administrator Marc Sweet arrived shortly thereafter.

The investigation consisted of the following: during the initial visit conducted on 11/14/2023, LPA Erik Zaragoza obtained copies of the staff roster, client roster, along with the Physician's Report, and Individualized Program Plan (IPP) for Client #1 (C1). LPA also conducted interviews with Staff #1 - 4 (S1 - S4), and also interviewed Clients #2 and #3 (C2 - C3). During today's visit, LPA interviewed C1.

The investigation revealed the following: in regards to the allegation "Client was physically attacked while in care", it is alleged that an unidentified individual put their hands on C1 and hit C1 on the evening of 11/3/2023.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023

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 28-AS-20231106153525

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SUNSHINE RESIDENTIAL HOME	FACILITY NUMBER: 198602615
	VISIT DATE: 11/17/2023

NARRATIVE

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During interviews with the clients, it was revealed that on the date of 11/3/2023, C1 and C2 got into an argument over a text message that was sent between them, and it led to a verbal altercation that escalated, lading to C2 pushing C1 with their elbow. C2 admitted that C2 and C1 got into an argument that evening that did escalate, and that staff intervened to de-escalate the situation. During an interview with C1, C1 explained that they got into a verbal argument with C2 which led to C2 pushing C1 with C2's elbow, however C1 explained that staff intervened immediately within seconds. During interviews with Staff, S1 - S4 explained that there was an altercation between C1 and C2 that began with them yelling at each other, and ultimately led to C2 shoving C1 with their elbow, however S2 intervened immediately to separate the two clients so that situation would not escalate further.

Regarding the allegation that "Staff did not seek timely medical attention for the client", it was reported that C1 was asking for help while C2 hit them, but staff remained in the living room for 10 minutes before they checked to see if C1 was okay. During interviews with the clients, both C1 and C2 explained that the staff intervened immediately during their argument in order to separate them so that it would not escalate any further. C1 additionally stated that they did not receive any injuries or cuts that required medical attention. During interviews with the staff, S1 - S4 all explained that they intervened immediately in order to break up the altercation between the 2 clients, and that C1 did not sustain any injuries that would require medical attention.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview held, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023

LIC9099 (FAS) - (06/04)

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