306004564-10-7-2020-22-AS-AORZ-BUBUYU-20201012160032

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004564
Report Date: 10/07/2020
Date Signed: 10/07/2020 03:33:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/01/2020 and conducted by Evaluator Jenifer Tirre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200601154643

FACILITY NAME:	SUNRISE OF HUNTINGTON BEACH		FACILITY NUMBER:	306004564
ADMINISTRATOR:	MENSAH, ERIC		FACILITY TYPE:	740
ADDRESS:	7401 & 7351 YORKTOWN AVE		TELEPHONE:	(714) 536-3032
CITY:	HUNTINGTON	STATE: CA	ZIP CODE:	92648
CAPACITY:	142	CENSUS: 95	DATE:	10/07/2020
		UNANNOUNCED	TIME BEGAN:	02:47 PM
MET WITH:	Administrator, Eric Mensah		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Licensee is not answering communications to the authorized representative promptly or appropriately.

Facility has not provided an itemized statement that lists all separate charges incurred by the resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jenifer Tirre contacted the facility via telephone to deliver findings on a Complaint Investigation via telephone due to COVID-19 and pre-cautionary measures. LPA identified self and discussed the purpose of the call and the elements of the allegations with Administrator Eric Mensah.

During the investigation, LPA’s Jenifer Tirre and Kimberly Lyman interviewed staff as well as toured the facility via Face Time. Regarding the allegation Licensee is not answering communications to the authorized representative promptly or appropriately, the investigation revealed that 3 out of 3 Sunrise Staff have confirmed that appropriate notifications have been sent out in timely manner. Regarding the allegation Facility has not provided an itemized statement that lists all separate charges incurred by the resident, the investigation revealed that multiple staff have discussed charges with Resident 1’s (R1) responsible party. Investigation also revealed that R1’s Resident Agreement states the following: Community will provide a monthly statement itemizing fees, charges, payments received and showing the balance due. If Residents account is not paid in full by the first of the month CONT ON LIC 9099C DATED 10/7/2020

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2020

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 22-AS-20200601154643

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: SUNRISE OF HUNTINGTON BEACH	FACILITY NUMBER: 306004564
	VISIT DATE: 10/07/2020

NARRATIVE

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, a late fee will be assessed on the outstanding balance of one and one quarter percent. During an absence from the community resident is responsible for payment of the base fee and all service level fees through the third day of absence. Agreement also states during a suite hold, upon return the resident continues to meet the community’s admission criteria and all fees and charges incurred by the resident have been paid. The Resident Agreement has been signed by responsible party for R1.

This agency has investigated the complaint alleging Licensee is not answering communications to the authorized representative promptly or appropriately and Facility has not provided an itemized statement that lists all separate charges incurred by the resident. Based on documents reviewed and interviews conducted, the allegations are deemed UNSUBSTANTIATED. 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. An exit interview was conducted with Administrator via telephone and a copy of this report along with LIC 811- Confidential Names list was provided. An electronic read receipt confirms receiving these documents

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Jenifer Tirre	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 10/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2020

LIC9099 (FAS) - (06/04)

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