<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005180
Report Date: 09/16/2021
Date Signed: 10/14/2021 11:25:39 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:SUNRISE ASSISTED LIVING OF SACRAMENTOFACILITY NUMBER:
347005180
ADMINISTRATOR:SARA WEININGERFACILITY TYPE:
740
ADDRESS:345 MUNROE STTELEPHONE:
(916) 486-0200
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:70CENSUS: 55DATE:
09/16/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
05:00 PM
MET WITH:Sara Weininger, Administrator TIME COMPLETED:
05:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced on 9/16/2021 to deliver findings to a complaint and issue a related citation found during the course of the investigation,. LPA met with Sara Weininger, Administrator, and explained purpose of inspection. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms and completed a facility risk assessment. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask.

During the course of the investigation, the Department investigated an additional allegation that FaceTime calls were not conducted timely after being requested by resident's family members. Resident’s family stated that from 4/12/2020- 4/15/2020h, they asked repeatedly, verbally, for a Facetime visit or call with resident and the facility promised daily they would set up a call. LPA reviewed a letter the facility sent to resident families on 4/15/2020 stating they had obtained additional computer tablets to allow all residents to enjoy virtual visits with family. LPA reviewed an e-mail letter dated 4/17/ 2020 (4:00 pm) to the Regional Director, from resident’s family member, asking for an immediate Facetime call or phone call with resident, who had recently conntracted Covid-19. LPA reviewed FaceTime Schedules provided by the facility for 4/14/2020- 4/15/2020. On 4/14/2020, resident’s name and family member/contact information is listed at the bottom of the schedule, but there is not a designated time listed for when the call was made. On 4/15/2020, resident’s name is listed next to 1:30 pm appointment time. Executive Director stated she received verbal confirmation from a staff member that FaceTime calls were made on 4/17/2020 and on 4/18/2020 with resident’s family. Resident’s representative stated that the family was finally able to have a Facetime visit on Friday, 4/17/2020, and again on Sunday, 4/19/2020, but the resident was very incoherent by this time, stating the reason a call wasn’t facilitated earlier was due to a staffing shortage. Based on information obtained, the facility had documented that a FaceTime call had been requested by the family by/on 4/14/2020, but a call was not made until on/around 4/18/2020. See 809D page for citation issued. Exit interview. Copy of report and appeal rights provided to facility.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: SUNRISE ASSISTED LIVING OF SACRAMENTO
FACILITY NUMBER: 347005180
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
10/15/2021
Section Cited

1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (9) To have communications to the licensee from their representatives answered promptly and appropriately. This requirement is not met as evidenced by:

8
9
10
11
12
13
14
Based on interviews and documentation reviewed, the Licensee did not ensure that communication with resident's representative, specifically multiple requests for a FaceTime call, were answered timely, which posed a potential personal rights violation to resident (R1) in care.
8
9
10
11
12
13
14

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: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 09/16/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/16/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2