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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603294
Report Date: 09/13/2023
Date Signed: 09/18/2023 07:10:47 AM

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
09/11/2023 and conducted by Evaluator Pamela Bunker
COMPLAINT CONTROL NUMBER: 11-AS-20230911084602
FACILITY NAME:SUNSHINE ASSISTED LIVINGFACILITY NUMBER:
198603294
ADMINISTRATOR:MARY MONTIANOFACILITY TYPE:
735
ADDRESS:3141 EUCLID AVETELEPHONE:
(310) 638-3847
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:68CENSUS: 50DATE:
09/13/2023
UNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Maria Jane MontianoTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not adequately supervise a resident who wandered away from the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Wednesday, September 13, 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met Administrator Mary Jane Montiano. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker interviewed staff members 1-3 (S1-S3) and residents 1-5 (R1-R5). LPA Bunker asked questions relevant to the nature of the complaint. S1-S3 and R1-R5 stated residents are adequately supervised and residents are not wandering away from the facility. S1-S3 and R1-R5 stated staff is aware of residents' whereabouts. S1-S3 stated residents are provided with the necessary care and supervision. S1-S3 stated staff assist residents with their daily needs. S1-S3 and R1-R5 stated this is not a locked facility. S1-S3 stated staff communicates with the resident regarding the resident's care and supervision. LPA Bunker requested copies of supporting documents.
See continued LIC9099-C page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
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 2
Control Number 11-AS-20230911084602
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: 09/13/2023
NARRATIVE
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Continued LIC9099-C page 2
Allegation: Staff did not adequately supervise a resident who wandered away from the facility.
Staff members 1-3 (S1-S3) and residents 1-5 (R1-R5) interviewed have consistently affirmed that residents are under sufficient supervision and do not exhibit a tendency to wander away from the facility. S1-S3 and R1-R5 stated that this is not a secured or locked facility, and residents retain their personal rights, including the ability to sign in and out as they choose. Staff members maintain vigilant awareness of the residents' locations and activities. S1 stated regarding the incident involving St. Francis Medical Center, it should be clarified that this facility is not a nursing home, and residents here have the autonomy to leave the premises at their discretion. Therefore, staff have emphasized their vigilance in keeping track of residents' whereabouts and firmly denied any allegations of neglect in this regard.

Investigation revealed the following: Through interviews with staff members 1 to 3 (S1-S3) and residents 1 to 5 (R1-R5), it has been consistently affirmed that residents receive appropriate supervision, and staff diligently provides them with the requisite care and oversight. It's essential to clarify that this facility is classified as assisted living, not a locked or secure facility typically associated with nursing homes. S1 stated that the incident involving St. Francis Medical Center reflects a misunderstanding, as the center wrongly assumed that their residents were from a locked facility. Residents at their facility retain the right to sign out and exercise their freedom to come and go as they please, within the framework of our established house rules. S1-S3 and R1-R5 alike confirm that staff members maintain an informed awareness of residents' locations and activities, and there have been no cases of residents eloping from the facility. In a recent incident, a resident fell ill shortly after leaving the facility while engaged in community activities and was subsequently transported to the hospital for observation. S1 reported that the resident has since recovered and returned to our facility on the same day. S1 stated that this incident was reported to the resident's next of kin and all the appropriate agencies in a timely manner. S1-S3 stated the facility staff is committed to adhering to residents' personal rights while providing necessary care and supervision. S1-S3 categorically denies any allegations of neglect related to this matter.
Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the 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 deemed unsubstantiated. A copy of the Complaint Investigation Report LIC9099 & LIC9099-C, was provided to Administrator Mary Jane Montiano. There were no deficiencies cited. An exit interview was conducted.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2