198603294-2-8-2024-11-AS-UCOL-D2QR9P-20240223114952

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603294
Report Date: 02/08/2024
Date Signed: 02/08/2024 04:55:36 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
02/06/2024 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20240206081931

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: 56	DATE:	02/08/2024
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Mary Jane Montiano - Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff does not ensure bedroom furniture is in good repair
Staff did not ensure showering assistance was provided to resident in care
Staff speak inappropriately to resident in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced complaint visit on 02/08/2024 around 8:00 AM. LPA explained the purpose of the visit and was accompanied by the Administrator Jane Montiano inside and outside the facility during this inspection.

The investigation consisted of the following: Request of Facility Documents & Review of Documents, Facility Inspection specifically in the Medication Room and Client Bedrooms, Interviews with Staff and Clients. LPA reviewed 5 client files specifically their Admission Agreement, Appraisal/Needs and Services Plan, Personal Rights, Physicians Report, Medication Administration Record (MAR), Centrally Stored Medication and Destruction Report. Furthermore, LPA reviewed documents: Residents Showers, Client Roster, Staff Roster/Schedule, Transportation Services, Resident Shower Slips, and Driver Weekly Vehicle Inspection Report. The investigation consisted of 7 out of 56 client interviews and 5 staff interviews which included the Cook, Caregiver, Medical Technician, Administrator, and Driver.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

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-20240206081931

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: 02/08/2024

NARRATIVE

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Regarding the allegation “Staff does not ensure bedroom furniture is in good repair,” that clients bedroom furniture is in is in disrepair. The investigation revealed that clients’ bedroom furniture is in good repair. LPA inspected over 10 client bedrooms and observed furniture in good repair. Interviews conducted indicated the following: 6 out of 7 clients indicated that they are satisfied with their furniture, and 1 out 7 client interviews indicated that they received a new piece of furniture within a week of their request, and staff interviews indicated that caregivers and housekeepers are responsible to verifying that furniture is in good repair and maintenance is responsible for fixing broken furniture or replacing furniture.

Regarding the allegation “Staff did not ensure showering assistance was provided to resident in care,” that staff members did not ensure showering assistance to clients. The investigation revealed that the facility provides showering assistance to clients in care. Record reviews indicate that there is a Resident Shower Schedule and a Resident Shower Slip indicating if client refused or accepted to take a shower. Interviews conducted indicate the following: 4 out 5 staff interviews indicated that the facility offers showering assistance, 6 out 7 client interviews indicated that the facility assist clients with showers if clients request assistance, 4 out 5 clients who receive assistance with showers indicated that they are satisfied with the service.

Regarding the allegation “Staff speak inappropriately to resident in care,” that staff spoke to clients in care in a disrespectful manner. The investigation revealed that facility staff are appropriate and respectful towards clients in care. Interviews conducted indicated the following: 6 out of 7 client interviews indicated that facility staff speak to them appropriately and with respect.

Regarding the allegations “Staff does not ensure bedroom furniture is in good repair; Staff did not ensure showering assistance was provided to resident in care; Staff speak inappropriately to resident in care” the allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violations occurred, therefore the allegations are unsubstantiated

There were no deficiencies cited based on LPA observation, interviews conducted and record review in accordance with the California Code of Regulations, Title 22.

An exit interview was conducted, and a copy of this report was provided to the administrator.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024

LIC9099 (FAS) - (06/04)

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