306005223-9-23-2022-22-AS-SSAS-CJRVKQ-20220930163044

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 09/23/2022
Date Signed: 09/23/2022 01:32:47 PM

Substantiated

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
11/15/2021 and conducted by Evaluator Kathrina Chin

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20211115103854

FACILITY NAME:	SUNNYCREST SENIOR LIVING		FACILITY NUMBER:	306005223
ADMINISTRATOR:	HEATHER YOST		FACILITY TYPE:	740
ADDRESS:	1925 SUNNY CREST DRIVE		TELEPHONE:	(714) 992-1999
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY:	210	CENSUS: 75	DATE:	09/23/2022
		UNANNOUNCED	TIME BEGAN:	12:42 PM
MET WITH:	Melanie Washington, Executive Director		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Staff are not assisting residents in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Kathrina Chin conducted an unannounced visit for the purpose of delivering the findings on a complaint investigation. LPA met with Melanie Washington, Executive Director.

On November 18, 2021, LPA Chin interviewed four residents and two staff members. Heather Yost, Executive Director during that time and Resident Care Director stated that they have installed a new auditory call system on November 8, 2021 for the facility and they have had many issues with the new system. There were many times that the call system was not working properly. Heather Yost stated that she had the vendor who installed the auditory signal system come out and fix the problem numerous times. As a result of the auditory call system not working properly, staff were unable to respond to residents on a timely basis after the resident pressed the auditory call system.

(Continued LIC 9099)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2838
LICENSING EVALUATOR NAME: Kathrina Chin	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

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-20211115103854

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: SUNNYCREST SENIOR LIVING	FACILITY NUMBER: 306005223
	VISIT DATE: 09/23/2022

NARRATIVE

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R1 who is President of the Resident Council and she has received many complaints from residents that they have been waiting a long time for staff to respond for assistance. Resident 2 stated that he has waited a long time because when he pressed the call signal system, it shows a different room number. This what the facility staff have told him and he was told that this was going to be fixed. Resident 3 stated that she has waited thirty minutes to one hour recently. Resident 4 stated that he has waited for about one hour on a daily basis for assistance.

Based on the information gathered during the investigation and review of all documents obtained, the following allegation is substantiated: Staff are not assisting residents in a timely manner.

Based on LPA's observations and conducted interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The following deficiencies are cited today as per Title 22, Division 6, of the California Code of Regulations.
An exit interview was conducted along with appeal rights were provided and a copy of this report was left.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2838
LICENSING EVALUATOR NAME: Kathrina Chin	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20211115103854

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: SUNNYCREST SENIOR LIVING	FACILITY NUMBER: 306005223
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/23/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/26/2022 Section Cited CCR 87303(i)(1)(A)	1 2 3 4 5 6 7	Maintenance and Operation. Facilities shall have signal systems which shall meet the following criteria:(1) All facilities licensed for 16 or more and all residential facilities having separate floor or buildings shall have a signal system which shall: (A)Operate from each resident's living unit. This requirement is not being met as evidenced by: Based by interviews	1 2 3 4 5 6 7	Heather Yost, Executive Director during that timeframe called the signal alarm vendor to check and fix the new signal system.
	8 9 10 11 12 13 14	file review and observation, Administrator and staff admitted that a new auditory call system was installed on November 8, 2021 was not working properly which caused delays for staff to respond to residents requesting assistance when they pushed the auditory call system. This poses an immediate health & safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 703-2838
LICENSING EVALUATOR NAME: Kathrina Chin	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

LIC9099 (FAS) - (06/04)

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