342700705-9-26-2022-25-AS-KHOS-CK4KSF-20221011080929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 342700705
Report Date: 09/26/2022
Date Signed: 09/26/2022 11:48:25 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 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
06/17/2022 and conducted by Evaluator Todd Tryon

COMPLAINT CONTROL NUMBER: 25-AS-20220617170236

FACILITY NAME:	SUN OAK ASSISTED LIVING		FACILITY NUMBER:	342700705
ADMINISTRATOR:	KEY, KAYE		FACILITY TYPE:	740
ADDRESS:	7241 CANELO HILLS DRIVE		TELEPHONE:	(916) 722-2800
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	78	CENSUS: 42	DATE:	09/26/2022
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Kaye Key		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility staff fail to shower resident
Facility staff do not provide care and supervision to limit falls
Facility staff do not manage resident's incontinence
Facility staff fail to assist resident with adequate food intake
Facility failed to include power of attorney in medication decisions
Facility failed to safeguard resident's clothes.
Facility did not ensure personal care needs were met.
Family was not informed of resident's medical issue.

INVESTIGATION FINDINGS:

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On 9/26/2022 LPA Tryon visited the facility to complete working on the complaiint. LPA met with Kaye Key, Executive Diredtor. During the course of the investigation, LPA has spoken with the Admnistrator and staff, observed resident, reviewed resident/facility documents, interviewed witnesses.
Regarding the allegation that the facility fails to shower the resident, LPA interviewed 7 of 15 staff and reviewed documenation. LPA learned that resident R1 dos not like to take showers most of the time and showers can be challenging. Staff often gets hit, kicked, bit and scratched. R1 frequesntly refuses to shower, which is her right. Despite this, there are certain staff who are able to work with R1 enough to complete showers at least 2 or 3 times per week. It appears that the staff overall tries very hard to make sure R1 is showered. Therefore, LPA finds that the allegation is Unfounded.
Regarding the allegation that facility staff do not provide care and supervision to limit falls: LPA has spoken with 7/15 staff, reviewed records. LPA learned that there is not a doctor order on file requiring a walker be used. The staff do attempt to encourage R1 to use her walker when walking, but R1 is very resistant to using

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

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-20220617170236

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: SUN OAK ASSISTED LIVING	FACILITY NUMBER: 342700705
	VISIT DATE: 09/26/2022

NARRATIVE

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the walker and often refuses. LPA learned that staff do try to walk with R1 when she refused the walker, try to keep an eye on her for safety, etc. Although R1 has had falls, it appears that staff does attempt to encourage use of the walker and tries to monitor R1 as much as possible. LPA cannot find any evidence that staff is acting neglectful towards R1. Staff is not required to have "eyes on" residents 24 hours, and residents are allowed privacy and choice in their lives. Therefore, the allegation is UNFOUNDED.

Regarding the allegation that staff do not manage residents incontinence, LPA has spoken with 7/15 staff, reviewed records. LPA learned that staff attempt to encourage R1 to use the bathroom and check her roughly every 2 hours. R1 is often not cooperative with checking/toileting and changing, refuses changes, etc. It appears that staff do attempt to work with R1 and keep her as clean as possible. The allegation is UNFOUNDED.

Regarding the allegation that Facility staff fail to assist resident with adequate food intake, LPA has spoken with 7/15 staff and reviewed records. Staff overall relate that R1 does eat well. R1 falls asleep frequently including during meals. Staff attempt to wake her to eat, but she often refuses to wake at that time. There is always food kept for R1 for when she is awake. She is also offered snacks, which she almost always accepts and eats. In reviewing weight charts for R1 it appear that she has NOT lost weight, has actually gained a little. Therefore, LPA finds that the allegation is UNFOUNDED.

Regarding the allegation that Facility failed to include power of attorney in medication decisions, through interview of 7/15 staff and review of records, LPA learned that the family is responsible for all of R1's medical appointments, refills and picks up medications, takes R1 to appointment, etc. There are notes that staff consults/notifies family when issues arise, refills are needed, etc. LPA can find no proof that the facility failed to include the responsible party in any decisions. Allegation is UNFOUNDED.

Regarding the allegation that Facility failed to safeguard resident's clothes, through interview of 7/15 staff and review of documentation, LPA learned that the responsible party refused the offer of staff doing an initial inventory. In speaking with staff, LPA learned that staff try to keep residents clothes separate and returned to their room after the laundry. However, names on clothes may wash off after a time, clothes can get misplaced, etc. LPA also learned that R1 may "borrow" other residents' clothes from their rooms at times. Every attempt is made to keep each person's belongings in that person's room. Allegation is UNFOUNDED.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 25-AS-20220617170236

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: SUN OAK ASSISTED LIVING	FACILITY NUMBER: 342700705
	VISIT DATE: 09/26/2022

NARRATIVE

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Regarding the allegation that the Facility did not ensure personal care needs were met: This allegation referred in particular to R1's toenails becoming long. Through interview of 7/15 staff, LPA learned that facility staff at Sun Oak are NOT allowed to cut resident toenails. This is generally taken care of by family, responsible parties; individuals are seen by a Podiatrist to have toenail trims; or are taken out at times to a nail salon, doctor, etc. LPA learned that the podiatrist did not come into the facility to do toenails during any time when COVID positive individuals were in the building. LPA learned that the responsible person for R1 takes her out every 3 months to a salon for her toenails to be done. On a recent podiatrist visit, LPA learned that the service was offered to R1, but the responsible person did not agree to have R1 seen. Therefore, it appears that the facility has made attempts to ensure R1 had toenail trims; and that her toenails have been done by outside providers. Allegation is UNFOUNDED.

Regarding the allegation that Family was not informed of resident's medical issue: this referred to alleged "weeping" sores on the legs of R1. In reviewing records and speaking with 7/15 staff, staff could not recall R1 having "weeping" sores on her legs. Staff did confirm that R1's legs do tend to swell. R1 takes medications for this, and the responsible party is aware of this situation. It appears that there have been times when medications for the swelling ran out and staff did inform the responsible party, but refills did not get to the facility, despite staffs repeated requests/notices. Since the responsible party is the person who picks up refills, the RP is notified when there is something going on, meds needs refills, etc.
Allegation is UNFOUNDED.

A finding that an allegation is UNFOUNDED means that the allegation is false, could not have happened, and/or is without a reasonable basis.

No deficiencies were issued as a result of this complaint. Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd Tryon	TELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

LIC9099 (FAS) - (06/04)

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