198603294-7-2-2025-11-AS-EMAZ-DM9T9E-20251008143149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603294
Report Date: 07/02/2025
Date Signed: 07/02/2025 04:44:41 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, 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
06/26/2025 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 11-AS-20250626080242

FACILITY NAME:	SUNSHINE ASSISTED LIVING		FACILITY NUMBER:	198603294
ADMINISTRATOR:	MARY MONTIANO		FACILITY TYPE:	735
ADDRESS:	3141 EUCLID AVE		TELEPHONE:	(310) 638-3847
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	68	CENSUS: 66	DATE:	07/02/2025
		UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Mary 'Jane' Montiano		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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The client is being abused and maltreated at the facility.

INVESTIGATION FINDINGS:

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On 07/02/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Administrator, Mary ‘Jane’ Montiano, and the purpose of today’s visit was explained. LPA was granted entry into the facility.

The investigation consisted of the following:
During today's visit, LPA toured the facility, interviewed Staff S1-S5, interviewed Clients C1-C7, and received documents pertinent to the investigation. The following documents were received and reviewed Staff Roster, Staff Schedule, Client Roster, Client Shower Schedule, Clients Physician’s Report, Physician Orders, Medication Administration Record (MAR), Needs and Service Plan, Preplacement Appraisal Information, P&I Records, and Admission Agreement.
The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

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 3

Control Number 11-AS-20250626080242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUNSHINE ASSISTED LIVING	FACILITY NUMBER: 198603294
	VISIT DATE: 07/02/2025

NARRATIVE

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Allegation: The client is being abused and maltreated at the facility
The allegation alleges clients are ignored by staff, not being provided with food, not assisted with bathing, not assisted with grooming, not provided with their medications, and takes their money.

During the facility visit, LPA observed clients were clean and groomed. LPA observed clients coming to the medication room to get their medications. LPA observed staff escorting clients to the dining room for meals. LPA inspected the kitchen and observed it to be clean and sanitary. During the kitchen inspection, LPA observed a 3-day supply of perishable foods and a 7-day supply of non-perishable foods. LPA observed lunch and dinner being served. LPA observed an ample amount of food being provided and some residents were served seconds when requested. LPA reviewed the P&I for five (5) clients. LPA observed five (5) out of five (5) client’s monies is consistent with the client’s Record of Client’s Safeguarded Cash Resources.

LPA conducted a client file review for six (6) clients. LPA reviewed, Client C1’s Physician’s Report (dated 11/22/2024) and observed C1 is able to bathe self, dress and groom self, able to manage own cash resources, and is not able to administer own medications, not able to administer own PRN medications, and is not able to store own medications. LPA received and reviewed Client C1’s Appraisal/Needs and Service Plan (dated 12/23/2024) that indicates C1 handles their own finances, is able to do their own ADLs with minimum assistance. LPA received and reviewed the Client Shower Schedule that has C1 listed for assistance with showers twice a week.
LPA conducted a medication review for six (6) clients. LPA reviewed Client C1-C6’s Physician Orders, MAR, and medications. LPA observed six (6) out of six (6) clients’ medications are consistent with properly documented records.

During interviews with Staff S1-S5, were asked if any clients in care have been abused or neglected, five (5) out of five (5) stated no, to their knowledge no clients have been abused or neglected. Additionally, Staff S1-S5 were asked if any client or their family have reported abuse or neglect, five (5) out of five (5) no clients or their family has reported abuse or neglect.

During interviews with Clients C1-C7, were asked if staff have abused or neglected them, six (6) out of seven (7) stated they have not been abused or neglected by staff. No details were provided when client was asked about abuse or neglect. Additionally, during interviews with Client’s C1-C7, were asked if they receive their medications as prescribed, seven (7) out of seven (7) stated they receive their medications as prescribed. Client’s C1-C7, were asked if they receive ample amounts of food, seven (7) out of seven (7) stated they receive three (3) meals a day, snacks, and food is always available. Additionally, during interviews with

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20250626080242

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUNSHINE ASSISTED LIVING	FACILITY NUMBER: 198603294
	VISIT DATE: 07/02/2025

NARRATIVE

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Client’s C1-C7, were asked if they have access to their P&I, seven (7) out of seven (7) stated they have access to their money.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

During today’s visit, LPA did not observe or cite any deficiencies.

An exit interview was conducted with Administrator, Mary ‘Jane’ Montiano, and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2025

LIC9099 (FAS) - (06/04)

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