198603283-3-11-2025-28-AS-RORN-DFBM7R-20250401092154

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603283
Report Date: 03/11/2025
Date Signed: 03/11/2025 04:16:42 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 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
03/03/2025 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250303154859

FACILITY NAME:	VICTOR SUNSHINE RESIDENTIAL CARE		FACILITY NUMBER:	198603283
ADMINISTRATOR:	MORA, VICTOR OLIVER R		FACILITY TYPE:	735
ADDRESS:	1410 S. RIDLEY AVE.		TELEPHONE:	(626) 346-3498
CITY:	HACIENDA HEIGHTS	STATE: CA	ZIP CODE:	91745
CAPACITY:	4	CENSUS: 3	DATE:	03/11/2025
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Staff Karina Garcia		TIME COMPLETED:	04:25 PM

ALLEGATION(S):

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Staff did not accord resident privacy.
Staff lock client out of common areas

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an unnanounced complaint investigation visit regarding the allegations listed above. LPA met with staff Karina Garcia and the purpose of the visit was discussed. Administrator Victor Mora was contacted via phone call and informed of the visit.

On todays visit, LPA conducted the following: toured the physical plant, interviewed staff #1-#3 (S1-S3), interviewed clients #1-#3 (C1-C3), reviewed and collected copies of C1's file. The investigation revealed the following:

In regards to the allegation "Staff did not accord resident privacy" it is alleged that staff enter C1's room without permissions and the facility bathroom has no door knobs removing all privacy. (3) of (3) Staff interviewed denied the allegation. (2) of (3) Clients interviewed could not corroborate the allegation...

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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-20250303154859

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: VICTOR SUNSHINE RESIDENTIAL CARE	FACILITY NUMBER: 198603283
	VISIT DATE: 03/11/2025

NARRATIVE

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Interview with C1 stated that they left their television and video game system out in the living room and while they were out of the facility, one of the staff returned the items to C1s room. C1 stated to leave their door locked so the only way that happened was if staff accessed the room without permission. All staff interviewed denied the incident occurred and they do not access C1's room without permission. Regarding the door knob, C1 stated to have locked the door knob themselves to prevent other clients from using the bathroom and would remove the door knob themselves to go back in. Staff stated they observed the behavior and changed the door knob to one that can be opened with a key in order to prevent C1 from locking other clients out of the bathroom. LPA observed all bathroom doors and private rooms to have door knobs. Based on interviews, observations, and file review; 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.

In regards to the allegation "Staff lock client out of common areas" it is alleged staff are directed to not allow C1 access to the laundry room. (3) of (3) Staff interviewed denied the allegation. (2) of (3) Clients interviewed could not corroborate the allegation. Interviews show that on 2/28/25, the facility had a new washing machine installed. Staff stated that C1 wanted to use the washing machine and was asked if they could wait until Administrator arrived to go over guidance on using the new machine properly. S2 was the staff on shift who communicated this to C1. S2 stated to have closed the door to the laundry room but did not lock it or forbid C1 from using the machine. There is also a bathroom there for anyone to use, so the door is never locked. C1 stated they were having a bad day, and due to S2's lack of English speaking skills, believed that staff were personally not allowing C1 to use the laundry room and so they kicked the door down immediately. C1 could not say whether the door was actually locked or just closed. Based on interviews, observations, and file review; 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.

Exit Interview conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

LIC9099 (FAS) - (06/04)

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