347004635-5-16-2023-59-AS-MSEY-CRWLQK-20230517085740

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347004635
Report Date: 05/16/2023
Date Signed: 05/16/2023 12:25:21 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/28/2023 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20230328180729

FACILITY NAME:	SUNFLOWER'S HOME		FACILITY NUMBER:	347004635
ADMINISTRATOR:	MITITI, MELANIA		FACILITY TYPE:	740
ADDRESS:	8429 SUNRISE BLVD		TELEPHONE:	(916) 284-7360
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	6	CENSUS: 6	DATE:	05/16/2023
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Luciano Mititi, Co-Administrator and Melania Mititi, Co-Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Residents are chemically restrained with medication
Facility staff not fingerprint-cleared
Staff are using drugs while on duty
Facility staff are abusing residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver findings to complaint received on 03/28/2023. LPA met with Luciano Mititi, Co-Administrator, and Melania Mititi, Co-Administrator, and explained purpose of inspection. LPA observed staff in the ktichen and was advised staff are currently on a break. LPA observed (1) resident to be watching television in the common area and (5) residents in their rooms. There are currently (2) residents on hospice. The results of the investigation are as follows:

During the investigation, LPA interviewed (2) Administrators, (3) staff and (2) residents, reviewed personnel files for staff (S1-S3) and staffing schedules LPA also reviewed ordered medications to those being administered for (2) residents as well as Centrally Stored Medication Record (LIC625) and PRN documentation. The results of the investigation are as follows:

Allegation: Residents are chemically restrained with medication. Complaint alleges that staff are giving residents medication to keep them sleeping.
*cont on 9099C(1)...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20230328180729

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: SUNFLOWER'S HOME	FACILITY NUMBER: 347004635
	VISIT DATE: 05/16/2023

NARRATIVE

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9099C(1)... Medications were reviewed for (2) residents on 5/16/23, and it was determined that all medications are being administered as ordered with no discrepancies found. Medications are being logged correctly on the LIC625 and PRN medication is also being documented when given. Co-Administrator added a column to record "resident's response" on the PRN log, per Regulation 87465. Co-Administrator stated that no residents take cough syrup, which can cause drowsiness, on a regular basis.

One staff stated "Maybe once in a while, one resident wakes up to use the bathroom" at night. Another staff stated that residents sleep well through the night. Co-Administrator, Melania, stated that the Administrators are on-call during the night and care staff only works during the day.

One resident stated she receives her medications correctly and timely and "takes quite a bit of meds", and confirmed she receives the same meds every day. A second resident stated the Co-Administrator takes care of all of the meds- and puts them in little cups", and there are "no errors" with medications, she receives the same meds at the same time daily, and also receives showers as scheduled. All staff stated that the owner oversees all medications administered to the residents. Both Administrators stated that one of them will administer the medications to residents on a daily basis. LPA observed (4) of (6) residents to be awake during today's inspection. (2 residents are currently on hospice.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Facility staff not fingerprint-cleared. Complaint alleges that some staff are undocumented and are not finger-print cleared. LPA reviewed staffing records and schedules and confirmed that all staff are finger-print cleared and associated to the facility. In addition, LPA confirmed multiple staff's identity in person from a photo ID or passport provided.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

cont on 9099C(2)..

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20230328180729

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: SUNFLOWER'S HOME	FACILITY NUMBER: 347004635
	VISIT DATE: 05/16/2023

NARRATIVE

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9099C(2)...Allegation: Staff are using drugs while on duty. Complaint alleges that staff are using drugs while on duty.
One staff stated all staff are awake and able to do their job with a second staff stating that no staff are under the influence of any drug or alcohol while working. Both Administrators stated that one of them is always at the facility and oversees the care being provided.

One resident stated staff are doing their jobs safely and well, everything is good with care and confirmed they will help her when she needs assistance. A second resident stated all (3) staff are "doing a great job", 'they treat us beautifully", are always awake and alert and "never under the influence" of any drug/alcohol and "everything is on time". LPA observed staff to be competently assisting residents and able to perform their jobs on on 5/16/23, 4/5/23 and during another inspection in November 2022.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Allegation: Facility staff are abusing residents. Complaint alleges that staff are abusing residents with no specific details provided.

One resident stated staff are doing their jobs safely and well, everything is good with care and confirmed they will help her when she needs assistance. A second resident stated all (3) staff are "doing a great job", 'they treat us beautifully", are always awake and alert and "everything is on time". Co-Administrator stated she is at the facility daily and if there any concerns with resident care, she would address it immediately with the staff and resident. Co-Administrator that she trains her caregivers that "when the client is happy, everyone is happy". LPA observed staff to be competently assisting residents and able to perform their jobs on on 5/16/23, 4/5/23 and during another inspection in November 2022.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- means that the allegation is false, could not have happened, and/or is without a reasonable basis.

All allegations were determined to be unfounded. There are deficiencies cited and the complaint is being dismissed. Exit interview. Copy of report provided to Administrator.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina Calzada	TELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC9099 (FAS) - (06/04)

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