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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 04/22/2023
Date Signed: 04/22/2023 01:48:19 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
09/12/2022 and conducted by Evaluator Patricia Velazquez
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20220912082828
FACILITY NAME:SUNNYCREST SENIOR LIVINGFACILITY NUMBER:
306005223
ADMINISTRATOR:SARAH CLEESENFACILITY TYPE:
740
ADDRESS:1925 SUNNY CREST DRIVETELEPHONE:
(714) 992-1999
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:210CENSUS: 82DATE:
04/22/2023
UNANNOUNCEDTIME BEGAN:
11:16 AM
MET WITH:Gail Blessum - Business Office Director
Brenda Bravo, L.V.N. - Resident Care Director
TIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Staff do not respond to residents' call buttons in a timely manner
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Patricia Velazquez conducted an unannounced subsequent visit to deliver the findings of the investigation into the above allegations. LPA Velazquez was allowed entry into the facility and initially met with Vibrant Life Director Juli Sanchez and explained the purpose of the visit. LPA also met with Business Office Director Gail Blessum and Resident Care Director Brenda Bravo, L.V.N.

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 SantosTELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia VelazquezTELEPHONE: (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)
Page: 1 of 2
Control Number 22-AS-20220912082828
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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Throughout today's visit LPA Velazquez asked residents to press their pendants to ascertain the staff response time to their call for assistance. LPA Velazquez observed facility staff responded to the pendants between 1 and 10 minutes with an overall average response time of just under 5 minutes. Six of six individuals interviewed stated they are to respond to a resident's pull cord or pendant within 5 minutes of receiving the notification. LPA Velazquez observed care staff carrying walkie talkies where staff receive verbal notification of the room number that is requesting assistance. Five of six individuals interviewed stated staff responded to their pendants or pull cords between 10 - 15 minutes with one individual indicating the response time was longer than 15 minutes.

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: Staff do not respond to residents' call buttons in a timely manner 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 SantosTELEPHONE: (713) 334-2062
LICENSING EVALUATOR NAME: Patricia VelazquezTELEPHONE: (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)
Page: 2 of 2