306005223-4-22-2023-22-AS-SSAS-CREVGT-20230501162603

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 04/22/2023
Date Signed: 04/22/2023 01:43:46 PM

Unsubstantiated

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
07/27/2022 and conducted by Evaluator Patricia Velazquez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220727153122

FACILITY NAME:	SUNNYCREST SENIOR LIVING		FACILITY NUMBER:	306005223
ADMINISTRATOR:	SARAH CLEESEN		FACILITY TYPE:	740
ADDRESS:	1925 SUNNY CREST DRIVE		TELEPHONE:	(714) 992-1999
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY:	210	CENSUS: 82	DATE:	04/22/2023
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Gail Blessum - Business Office Director Brenda Bravo, L.V.N. - Resident Care Director		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Facility has inadequate staffing to meet resident's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced subsequent complaint visit to deliver the findings of the investigation into the above allegation. LPA Velazquez was allowed entry into the facility and initially met with Vibrant Life Director Juli Sanchez and explained the purpose of the visit. Business Office Director Gail Blessum and Resident Care Director Brenda Bravo, L.V.N. arrived later to assist LPA with the visit.

On today's visit LPA Velazquez conducted interviews with residents and staff. LPA also reviewed and requested copies of facility, resident, and staff records. During the course of the investigation the following was revealed: LPA Velazquez conducted interviews with residents and staff. LPA also reviewed facility, resident, and staff records. The records reviewed included Resident Face Sheets, Medication Lists, Physician's Reports, Sunnycrest Level of Care Assessments that describe how much care and assistance a resident requires, Preplacement Appraisal Information, Staff Training Records, and Staff Work Schedules.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia Velazquez	TELEPHONE: (949) 236-0556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2023

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-20220727153122

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: 04/22/2023

NARRATIVE

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Twelve of twelve individuals interviewed provided conflicting statements and could not corroborate the allegation. Ten of twelve individuals interviewed felt there was sufficient staff present to meet the needs of the residents. Four of twelve individuals interviewed stated the facility could use more staff to meet the needs of the residents.

Based on the observations made by LPA Patricia Velazquez, interviews which were conducted and the records that were reviewed, 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 following allegation: Facility has inadequate staffing to meet resident's needs is deemed UNSUBSTANTIATED.

An exit interview was conducted with Resident Care Director Brenda Bravo, L.V.N. and Business Office Director Gail Blessum and a copy of this report was provided at the time of this visit.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia Velazquez	TELEPHONE: (949) 236-0556
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2023

LIC9099 (FAS) - (06/04)

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