306005223-3-25-2025-22-AS-SSAS-DF826L-20250328170720

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005223
Report Date: 03/25/2025
Date Signed: 03/25/2025 06:17:21 PM

Substantiated

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
03/19/2025 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250319163927

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: 106	DATE:	03/25/2025
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Monica Aguirre		TIME COMPLETED:	06:15 PM

ALLEGATION(S):

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Facility staff are not abiding by the terms and conditions of the Admission Agreement.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to conduct the required 10-day visit to begin the investigation into the allegation listed above. LPA met with Assistant Executive Director (AED) Monica Aguirre and explained the reason for the visit. The investigation revealed the following. It was alleged the facility is not abiding by the admission agreement because on page 2 it states under Section A Living Accommodations, " 2. Utilities. Your apartment will be furnished with basic cable television hook-up, water, electricity, garbage removal, heat and air conditioning.". Staff reported that the TV channel guide is provided at the time of move in to all residents. The guide lists 52 channels. LPA and AED toured the facility. LPA observed the TV in the activity room receives 51 channels, channel 39 only showed the Direct TV logo and according to the channel list it should show, TVLand. LPA and the AED observed that in Resident 1's (R1) room that the TV did not have any sound on channel 15 but had sound on all the other channels.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025

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 3

Control Number 22-AS-20250319163927

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: 03/25/2025

NARRATIVE

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LPA observed 5 channels out of the 51 received had a poor quality picture with static interference. LPA and the AED observed the TV in Resident 2's room (R2) that 5 channels received had a poor quality picture with static interference. LPA interviewed the maintenance director and the activities director who reported the problem has been ongoing since around January 2025. 3 out of 3 residents interviewed verified this report. The Executive Director stated that the cable provider has been out at least 3 times in the last 30 days but the problem is ongoing. Based on the evidence gathered the preponderance of evidence standard has been met therefore the allegation is substantiated. Deficiencies are being cited per Title 22 Division 6 of California Code of Regulations. An exit interview was conducted and a copy of the report along with appeal rights was provided.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 22-AS-20250319163927

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/25/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/25/2025 Section Cited CCR 87507(f)	1 2 3 4 5 6 7	The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement is not being met as evidenced by... LPA observed that the admission agreeement states basic cable	1 2 3 4 5 6 7	License agrees to have the cable TV in the facility fixed so all residents can view channels with sound and good picture quality without any static or distortion.
	8 9 10 11 12 13 14	television hook-up will be provided but channel 39 is not being provided, 5 out of the 51 channels have poor picture quality with static and channel 15 does not have sound for R1, this poses a potential personal rights 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) 334-2062
LICENSING EVALUATOR NAME: Joseph Alejandre	TELEPHONE: 714-705-6018
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2025

LIC9099 (FAS) - (06/04)

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