315001968-8-2-2022-25-AS-LMUZ-CGXP9D-20220803110659

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 315001968
Report Date: 08/02/2022
Date Signed: 08/02/2022 01:54:17 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
03/28/2022 and conducted by Evaluator Talwinder Bains

COMPLAINT CONTROL NUMBER: 25-AS-20220328120243

FACILITY NAME:	SUNRISE OF ROCKLIN		FACILITY NUMBER:	315001968
ADMINISTRATOR:	MORADHASEL, ROUZBEH		FACILITY TYPE:	740
ADDRESS:	6100 SIERRA COLLEGE BLVD		TELEPHONE:	(916) 632-3003
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	82	CENSUS: 62	DATE:	08/02/2022
		UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Marianne Richardson		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Facility failed to issue a refund.
Facility did not conduct an initial assessment for resident.
Facility did not follow resident's care plan.
Facility is advertising for services that are not being provided.

INVESTIGATION FINDINGS:

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On 08/02/22, Licensing Program Analyst (LPA) Talwinder Bains 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: N-95 Mask. Additionally, LPA was screened with temperature at the facility upon arrival.

**Report continued on LIC9099-C**

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

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 3

Control Number 25-AS-20220328120243

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: 08/02/2022

NARRATIVE

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Allegation: Facility failed to issue a refund.

Department reviewed facility records for the allegation from this complaint regarding refund from the facility to the family. Per allegation, facility refused to pay the proper refund to the family after R1 moved out from the facility. Records review revealed that R1 stayed at the facility from 02/27/22 till 03/10/22. After R1 moved out from facility on 03/10/22, facility offered to pay $4751 as remainder to the family but family refused that amount and want the full amount back due. Per record review, facility did offer to pay the remainder to the family as courtesy, but family refused amount.

Allegation: Facility did not conduct an initial assessment for resident.

The department conducted interviews regarding this allegation. Facility staff stated that initial assessment was completed on 02/27/22(Sunday), the day R1 was admitted to the facility. All staff, including caregivers, were aware of R1s needs and service plan. Department reviewed R1’s initial assessment documentation conducted by the facility.

Allegation: Facility did not follow resident’s care plan.

The department conducted interviews regarding this allegation. Interviews indicated that staff were aware of R1’s need based on R1’s needs and service plan. A review of documentation and interviews conducted revealed that staff were following R1’s needs and service plan as documented. After R1 medical records review and file review, department also concluded that facility nursing staff did communicate with R1 doctor, family and other required agencies for any health concerns for R1. Facility also notified CCLD for R1’s health updates per department reporting protocol.

**Report continued on LIC9099-C**

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 25-AS-20220328120243

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: 08/02/2022

NARRATIVE

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Allegation: Facility is advertising for services that are not being provided.

The department conducted interviews regarding the facility services to residents in care. During these interviews, residents and staff stated they are aware about all the services offered by facility and did not express any concerns or issues. Department also reviewed facility’s advertisements on social media, printed facility brochures and other modes of advertisements regarding facility’s offered services to residents in Assisted Living unit and Memory care unit. Department concluded that facility is advertising only those services which they are capable of within their scope of practice per Licensing requirements for Department of Social Services.

As a result of this investigation, LPA finds all above allegations 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.

No deficiencies are cited during today’s visit.

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

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder Bains	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC9099 (FAS) - (06/04)

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