306005223-1-22-2024-22-AS-SSAS-CZYVBE-20240130151726

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 01/22/2024
Date Signed: 01/22/2024 05:01:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
01/16/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240116104221

FACILITY NAME:	SUNNYCREST SENIOR LIVING		FACILITY NUMBER:	306005223
ADMINISTRATOR:	AGUIRRE, MONICA		FACILITY TYPE:	740
ADDRESS:	1925 SUNNY CREST DRIVE		TELEPHONE:	(714) 992-1999
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY:	210	CENSUS: 84	DATE:	01/22/2024
		UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Melanie Washington, Executive Director		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility is not abiding by the admission agreement

Facility admission agreement does not have description of services

Facility did not specify additional fees owed

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch conducted an unannounced visit to the facility for the purpose of following up on the investigation of the allegations listed above. LPA was greeted and granted entry by front desk staff after explaining the purpose of the visit. Executive Director Melanie Washington was present to assist with LPA's requests throughout the visit.

An initial complaint investigation visit took place on January 16, 2024. LPA requested and obtained records maintained at the facility for resident R1 along with copies of a prospective admission agreement drafted in anticipation of a facility-wide update of the admission packets following a change of ownership. One staff interview was conducted during the visit.

During the present visit, LPA requested the full census and reviewed four more resident records. A total of six resident interviews were either conducted or attempted in addition to one staff interview.
CONTINUED ON FORM LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
01/16/2024 and conducted by Evaluator Kevin Saborit-Guasch

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240116104221

FACILITY NAME:	SUNNYCREST SENIOR LIVING		FACILITY NUMBER:	306005223
ADMINISTRATOR:	AGUIRRE, MONICA		FACILITY TYPE:	740
ADDRESS:	1925 SUNNY CREST DRIVE		TELEPHONE:	(714) 992-1999
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY:	210	CENSUS: 84	DATE:	01/22/2024
		UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Melanie Washington, Executive Director		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

1
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5
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7
8
9

Facility did not obtain a proper medical evaluation for resident prior to admission

INVESTIGATION FINDINGS:

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Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 22-AS-20240116104221

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: SUNNYCREST SENIOR LIVING	FACILITY NUMBER: 306005223
	VISIT DATE: 01/22/2024

NARRATIVE

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CONTINUED FROM FORM LIC9099-A

Regarding the allegation that Facility did not obtain a proper medical evaluation for resident prior to admission, the following has been concluded: After prospective admission packets were provided to facility residents and/or their responsible parties, multiple parties interviewed stated that they had been confused by the inclusion of a blank assessment form in the packet that had been provided to them and thought that it did apply to each individually. During both visits conducted, LPA reviewed a random selection of six resident records, all of which were observed to include the required medical assessment. As a result, the allegation is found to be Unfounded, meaning that the allegation is false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted and a copy of this report was provided to a facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 22-AS-20240116104221

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: SUNNYCREST SENIOR LIVING	FACILITY NUMBER: 306005223
	VISIT DATE: 01/22/2024

NARRATIVE

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CONTINUED FROM FORM LIC9099

Regarding the allegation that Facility is not abiding by the admission agreement, the following has been concluded: Based on interviews and records reviewed, the facility changed ownership on December 18, 2023. On or around that time, the new management made an announcement and provided new admission agreements for review to residents and/or their responsible parties with an initial instruction to return these signed within 5 days. The instruction was later rescinded. At the time of the initial investigation, the updated packets are stated to not be in effect yet. A review of six randomly selected resident records showed that the initial agreements were still valid and in effect, both for recently admitted residents as well as residents with a longer admission period at the facility. At this time, the admission agreements on file are still in place and valid. The allegation is therefore found to be Unsubstantiated, meaning that there is not a preponderance of evidence to prove or refute the alleged violation occurred.

Regarding the allegations that Facility did not specify additional fees owed and Facility admission agreement does not have description of services, the following has been concluded: Both the initial admission agreements on file and the prospective documents provided for review include a list of the basic services provided as well as a list of the additional services available as well as the fee schedule for these. Assisted Living Care Levels are also described and the cost associated is described in both instances. Some of the residents and/or responsible parties interviewed described being confused by the fact that copies of the prospective admission packet indicated increased fees starting December 18, 2023 and expressed concerns that these amounts could be binding despite assurances to the contrary made by the facility's Executive Director. These concerns were compounded by the presence of an inaccurate balance amount on the invoices provided for January 2024 due to the inclusion of fees already paid prior to the change of ownership to the total balance owed. It was however determined that none of the fee structure had been modified at this time. As a result, the allegations are found to be Unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred.

One Technical Assistance Advisory Notes is attached to the present report. An exit interview was conducted and a copy of this report was provided to a facility representative.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch	TELEPHONE: (714) 497-8754
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2024

LIC9099 (FAS) - (06/04)

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