306005223-6-9-2023-22-AS-SSAS-CSS2BM-20230613171521

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 06/09/2023
Date Signed: 06/09/2023 03:22:58 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
09/14/2022 and conducted by Evaluator Patricia Velazquez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220914144627

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: 86	DATE:	06/09/2023
		UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Melanie Washington - Executive Director		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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The facility has insufficient staff
The facility provided inadequate incontinent care to resident
The Administrator does not respond to the responsible party concerns regarding residents care

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 allegations. LPA Velazquez was allowed entry into the facility, met with Executive Director (ED) Melanie Washington and explained the purpose of the visit.

On today's visit LPA Velazquez conducted interviews with residents and staff. LPA Velazquez also obtained copies of facility and resident records. During the course of the investigation the following was revealed. LPA Velazquez conducted interviews with residents and staff. LPA also reviewed facility and resident records. The records reviewed included Identification and Emergency Information, Preplacement Appraisal Information, Admission Record, Admission Orders, Sunnycrest Level of Care Assessments CA, Physician Communication Notes for Resident (R) #1, and R1's Hospital After Visit Summary for dates August 8, 2021 - September 10, 2021.

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: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

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-20220914144627

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: 06/09/2023

NARRATIVE

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Regarding the allegation: the facility has insufficient staff, 13 of 13 individuals interviewed provided conflicting statements and could not corroborate the allegation. 10 of 13 individuals interviewed felt the facility had sufficient staff to meet the needs of the residents in care. Regarding the allegation: the facility provided inadequate incontinent care to resident, 13 of 13 individuals interviewed provided conflicting statements and could not corroborate the allegation. During the visit dated May 12, 2023, LPA Velazquez observed 3 Caregivers attending to R1's incontinent needs. Per one of the Caregivers, R1 is changed regularly and no less than every 2 hours. The Reporting Party indicated the facility has improved with the incontinent care provided to R1. Regarding the allegation: the Administrator does not respond to the responsible party concerns regarding residents care, 13 of 13 individuals interviewed provided conflicting statements and could not corroborate the allegation with many stating the Administrator has been responsive regarding a resident's care. The Reporting Party stated communication with the Administrator has also improved since the complaint was originated.

Based on the observations made by LPA Patricia Velazquez, interviews which were conducted and the records that were reviewed, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the following allegations: The facility has insufficient staff, The facility provided inadequate incontinent care to resident, and The Administrator does not respond to the responsible party concerns regarding residents care, are deemed UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Melanie Washington 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: 06/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023

LIC9099 (FAS) - (06/04)

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