347005180-12-9-2021-27-AS-KHOS-C9QMFR-20211215083447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347005180
Report Date: 12/09/2021
Date Signed: 12/09/2021 09:12:08 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/10/2021 and conducted by Evaluator Avelina Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 27-AS-20210910081701

FACILITY NAME:	SUNRISE ASSISTED LIVING OF SACRAMENTO		FACILITY NUMBER:	347005180
ADMINISTRATOR:	SARA WEININGER		FACILITY TYPE:	740
ADDRESS:	345 MUNROE ST		TELEPHONE:	(916) 486-0200
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	70	CENSUS: 56	DATE:	12/09/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Sara Weininger		TIME COMPLETED:	09:15 AM

ALLEGATION(S):

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Staff are not answering resident calls/call buttons due to lack of staffing.
Resident's hygiene needs are not being met due to lack of staffing.
Resident was not able to go outside due to lack of staffing.

INVESTIGATION FINDINGS:

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On 12/09/2021 at 9:00 am, Licensing Program Analyst (LPA) Avelina Martinez arrived at the facility unannounced to deliver complaint findings. LPA met with Sara Weininger and explained the purpose of today’s visit.

Throughout the course of this investigation, LPA Martinez conducted interviews and reviewed facility records. LPA Martinez interviewed residents 1 thru 7. Residents 1 thru 6 reported having no issues with the call button response time, hygiene care, and not being able to go outside. Resident 3 reported she goes out for daily walks around the facility. Additionally, resident 7 reported not having any issues with call button response time, not being able to go outside, and hygiene services. Moreover, during an interview with R7, a care staff arrived at R7's room to give R7 a shower. In addition, LPA Martinez was provided bowel/ bladder and bathing documents, which indicated the various care tasks were being completed.

Continued...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Avelina Martinez	TELEPHONE: (916) 431-8935
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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 27-AS-20210910081701

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: SUNRISE ASSISTED LIVING OF SACRAMENTO	FACILITY NUMBER: 347005180
	VISIT DATE: 12/09/2021

NARRATIVE

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Furthermore, during a file review, there were no supporting documents to prove care managers were not responding to call buttons in a timely manner. LPA Martinez requested call button/call log supporting documents from witness 1 (W1), however, W1 did not submit documentation. LPA Martinez also reviewed facility work schedules for November and December 2021. The facility work scheduled shifts were filled. Additionally, staff 1 and staff 2 and staff 3 reported no issues with staffing.

Due to the above noted information, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, and therefore the allegations are unsubstantiated. There were no deficiencies cited at this visit. An exit Interview was conducted and a copy of the report was given to the facility.

SUPERVISOR'S NAME: Czarrina A Camilon-Lee	TELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Avelina Martinez	TELEPHONE: (916) 431-8935
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

LIC9099 (FAS) - (06/04)

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