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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 315001968
Report Date: 05/13/2022
Date Signed: 05/13/2022 03:06:39 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, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/14/2021 and conducted by Evaluator Jacob Williams
COMPLAINT CONTROL NUMBER: 25-AS-20210914155804
FACILITY NAME:SUNRISE OF ROCKLINFACILITY NUMBER:
315001968
ADMINISTRATOR:MORADHASEL, ROUZBEHFACILITY TYPE:
740
ADDRESS:6100 SIERRA COLLEGE BLVDTELEPHONE:
(916) 632-3003
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:82CENSUS: 57DATE:
05/13/2022
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH: Marianne Richardson, Executive DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff verbally abusing residents.
Facility not safeguarding resident belongings.
Not enough dining staff to serve residents.
Administrator not addressing resident concerns.
INVESTIGATION FINDINGS:
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 On 5/13/22, Licensing Program Analyst (LPA) Jacob Williams conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Marianne Richardson, Executive Director. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Upon arrival, completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened with temperature at the facility.

The department conducted records review and extensive interviews.
The department is unable to find and or meet the preponderance, per policy.

**Report continued on LIC9099-C**
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
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 6
Control Number 25-AS-20210914155804
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: SUNRISE OF ROCKLIN
FACILITY NUMBER: 315001968
VISIT DATE: 05/13/2022
NARRATIVE
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Allegation: Staff verbally abusing residents.

The facility had been using supplemental agency staff since May of 2021. The department interviewed several residents and staff members regarding the interactions of the agency staff. Of those interviewed, one single individual (R1) had noticed verbal abuse from an agency staff person. The consensus is that while the facility may be understaffed at times, the staff try to serve the residents with respect and dignity.

Allegation: Facility not safeguarding resident belongings.

The department interviewed several residents and staff members regarding safeguarding residents belongings, with emphasis on laundry. Through interviews and documents reviewed, it is determined that the facility encourages residents to label their clothes but does not require it. The facility also has a lost & found for laundry and other belongings. Of those interviewed, two residents had had their laundry lost at some point, but one received it back two weeks later, and another never received it again.

Allegation: Not enough dining staff to serve residents.

The department interviewed several residents and staff members regarding the facility not having enough dining staff to serve residents. R1 states staff only wake them up when they ring their pendant, and R2 once noticed two residents complaining because they were not brought to the dining room in time for breakfast. Of the others interviewed, they had no issues. S1, S2, S3, and S4 stated that residents are given the option for a room service trey if they cannot make it down to the dining hall, and S3 and S4 stated continental breakfast is offered at any time, even after 9am breakfast time.

**Report continued on LIC9099-C**

SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 25-AS-20210914155804
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: SUNRISE OF ROCKLIN
FACILITY NUMBER: 315001968
VISIT DATE: 05/13/2022
NARRATIVE
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Allegation: Administrator not addressing resident concerns.

The department interviewed several residents and staff members regarding the Executive Director not addressing resident concerns. S1 and S5 stated the Executive Director does not have or make time to fix issues with residents, but majority had no issues with the way she handles concerns. It is understood that the facility has been understaffed at times, and R3 stated the Executive Director has begun assisting in the dining room when needed.

As a result of this investigation, LPA finds allegation to be UNSUBSTANTIATED - A finding that the complaint is Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted and a copy of report left with Marianne Richardson, Executive Director.

SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/14/2021 and conducted by Evaluator Jacob Williams
COMPLAINT CONTROL NUMBER: 25-AS-20210914155804

FACILITY NAME:SUNRISE OF ROCKLINFACILITY NUMBER:
315001968
ADMINISTRATOR:MORADHASEL, ROUZBEHFACILITY TYPE:
740
ADDRESS:6100 SIERRA COLLEGE BLVDTELEPHONE:
(916) 632-3003
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:82CENSUS: DATE:
05/13/2022
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Marianne Richardson, Executive DirectorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Residents needs are not being met.
INVESTIGATION FINDINGS:
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13
 On 5/13/22, Licensing Program Analyst (LPA) Jacob Williams conducted an unannounced complaint investigation visit to deliver the findings for the above allegations and met with Marianne Richardson, Executive Director. Prior to initiating the complaint visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. Upon arrival, completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened with temperature at the facility.

The department conducted records review and extensive interviews.

The results of the investigation are as follows:

** Report continued on 9099-C **
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 25-AS-20210914155804
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: SUNRISE OF ROCKLIN
FACILITY NUMBER: 315001968
VISIT DATE: 05/13/2022
NARRATIVE
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Allegation: Residents needs are not being met.

Through document review, R1 pays for showers three times per week; during time of interview R1 stated it had been 6 days and counting since last shower, and that they once had to go 12 days without a shower. R3 pays for showers two times per week; states they do not receive two, and has to fight for the showers they do get. R4 pays for showers three times per week; states they rarely, if ever, receive that amount and claimed to have a breakdown the morning of interviews because it had been four days and counting without being bathed, and has not had his clothes changed in the same amount of time. R2 states his bed was not changed that week because staff never came to collect his dirty laundry on the past laundry day. It is understood that when clients press their pendant for assistance, it can take anywhere from 45 minutes to multiple hours for staff to respond. The department believes the facility being understaffed is a large reason for the aforementioned incidents.

Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegations are found to be SUBSTANTIATED. Per California Code of Regulations, Title 22 Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D page.

Exit interview was conducted and a copy of this report and appeal rights were provided to Marianne Richardson, Executive Director.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Citations on this Visit Report are Under Appeal!

Control Number 25-AS-20210914155804
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: SUNRISE OF ROCKLIN
FACILITY NUMBER: 315001968
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
05/16/2022
Section Cited
CCR
87411(a)
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87411(a) Personnel Requirements – General-Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.

This requirement is not met as evidenced by:
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Licensee to provide CCL with a plan by 5/16/2022 to ensure personnel will be sufficient in numbers and competent.
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Based upon observation and interview the Licensee failed to ensure staff are sufficient in numbers and competent to provide services necessary to meet resident needs.

This poses an immediate Health, Safety and/or Personal Rights risk to residents in care.
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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: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Jacob WilliamsTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6