198602887-8-6-2021-11-AS-JHAD-C5Y3E3-20210816181027

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602887
Report Date: 08/06/2021
Date Signed: 08/06/2021 11:45:58 AM

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
03/26/2021 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210326122739

FACILITY NAME:	SUNRISE ASSISTED LIVING OF HERMOSA BEACH		FACILITY NUMBER:	198602887
ADMINISTRATOR:	MORRIS, TRAVIS		FACILITY TYPE:	740
ADDRESS:	1837 PACIFIC COAST HWY		TELEPHONE:	(310) 937-0959
CITY:	HERMOSA BEACH	STATE: CA	ZIP CODE:	90254
CAPACITY:	142	CENSUS: 76	DATE:	08/06/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Travis Morris, Executive Director		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff are not sufficient in numbers to provide services necessary to meet residents' needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to deliver findings and decisions for the allegation listed above. Today’s complaint investigation was conducted with Travis Morris, the facility Executive Director

The investigation consisted of following: Interviews and Record reviews. On 03/30/21, LPA Soto interviewed witness and Executive Director Travis Morris. On 07/29/21, LPA Soto and LPA Coronel interviewed S#2 – S#6, R#1 – R#4. Toured the entire memory care unit. LPA Soto received the following documents on 07/29/21; Resident roster (Memory Care Unit,) staff roster, staff work schedules for (memory care unit.)

Based on the LPA's investigation, the investigation revealed the following. For Allegation – Staff are not sufficient in numbers to provide services necessary to meet residents' needs. Interviews conducted with Executive Director stated that the facility utilizes a computer system to determine the amount of staff needed, in order to provide care for all the residents needs in care.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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 11-AS-20210326122739

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 ASSISTED LIVING OF HERMOSA BEACH	FACILITY NUMBER: 198602887
	VISIT DATE: 08/06/2021

NARRATIVE

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They have 3 staff members for all 3 shifts (morning, evening, and night.) The interviews conducted with the staff, stated that they feel that the staff is enough, because they just hired a coordinator (Director) to help with the memory care unit. The changes that she has made has helped the staff in memory care, they do not feel stressed about completing their duties. Interviews with the R#1, stated that R#1’s needs were being met, the staff was sufficient. Interviews with R#2 – R#4, residents could not understand LPA’s questions. LPA Soto reviewed the staff schedules and it revealed that they were sufficient staff for the memory care unit. The interviews conducted and records review did not concur with above allegation.

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 with Travis Morris, Executive Director, and a hard copy was provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC9099 (FAS) - (06/04)

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