361880793-7-15-2024-18-AS-JDHS-D7PTMJ-20240731145114

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 361880793
Report Date: 07/15/2024
Date Signed: 07/15/2024 02:46:57 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/12/2021 and conducted by Evaluator Kathleen Banrasavong

COMPLAINT CONTROL NUMBER: 18-AS-20210512133124

FACILITY NAME:	SUNLIT GARDENS ASSISTED LIVING		FACILITY NUMBER:	361880793
ADMINISTRATOR:	STEVENSON, CHERYL		FACILITY TYPE:	740
ADDRESS:	9428 19TH STREET		TELEPHONE:	(909) 481-2600
CITY:	ALTA LOMA	STATE: CA	ZIP CODE:	91701
CAPACITY:	0	CENSUS: 69	DATE:	07/15/2024
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Executive Director, Tirso Del Junco		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility failed to provide resident with food and water causing resident's death.
Facility staff illegally placed resident on hospice.
Facility staff denied visitation.

INVESTIGATION FINDINGS:

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Licensing Program Analyst, (LPA) Kathleen Banrasavong conducted an unannounced visit to deliver findings for a complaint investigation regarding the above allegations. LPA met with Executive Director, Tirso Del Junco and LPA explained the purpose of the visit and the elements of the allegations. The investigation consisted of observation, interviews with staff members and residents, and records review. LPA was unable to interview pertinent parties, including Resident and additional witness. It was advised that Resident #1 passed away on March 1, 2021. LPA was unable to interview the additional witnesses for this investigation due to the inability to obtain contact.

On 05/12/2021, Community Care Licensing received a complaint alleging that facility staff failed to provide resident with food and water causing resident’s death, facility staff illegally placed residents on hospice, and facility staff denied visitation. It was reported that the facility failed to provide resident with food and water causing the resident’s death. LPA conducted interviews with the Executive Director, Lead Chef, Staff 1 (S1) who stated that they place orders for the food biweekly and food orders come in on Tuesday and Fridays.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

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 18-AS-20210512133124

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: SUNLIT GARDENS ASSISTED LIVING	FACILITY NUMBER: 361880793
	VISIT DATE: 07/15/2024

NARRATIVE

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S1 stated that there is enough food for all residents for breakfast, lunch, dinner. LPA made observations at the kitchen and pantry food supplies, which met Department regulations standards. LPA reviewed food orders and corroborated what was stated by the Executive Director and Lead Chef. LPA interviewed residents and staff members who were placed and employed from 2021, who stated that the facility provided adequate meals for the residents. No concerns were advised.

In regards to facility staff illegally placing resident on hospice. LPA contacted the hospice agency to attempt to interview staff who attended to R1. LPA was advised that the company is no longer in service as of December 21, 2023. LPA was unable to obtain any records of Resident #1. LPA attempted to interview the previous Memory Care Director at the time of the complaint, but LPA was unable to interview the staff member due to the staff member not returning the LPA’s phone calls. Information obtained from Executive Director stated that facility representatives only place residents that require hospice care, on hospice. Executive Director stated the facility discusses concerns with the resident’s doctor, who ultimately decides if the resident requires hospice care.

In regards to the staff denying visitation, LPA conducted interviews with staff member and residents who have been at the facility since 2021. The interviews conducted indicated there were no issues with visitors being allowed at the facility. Executive Director stated they have never denied visitation, unless there was a specific court order. In that case, they would follow the court orders. No further information was obtained to corroborate that the facility denied visitation.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 18-AS-20210512133124

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: SUNLIT GARDENS ASSISTED LIVING	FACILITY NUMBER: 361880793
	VISIT DATE: 07/15/2024

NARRATIVE

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Based on the LPA’s observation, interviews conducted, and record review, the allegations of facility staff failed to provide resident with food and water causing resident’s death, facility staff illegally placed residents on hospice, Facility staff denied visitation, are unsubstantiated. A finding of unsubstantiated means the allegations may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegations are unsubstantiated.

An exit interview was conducted and a copy of this report was discussed with and provided to the Executive Director, Tirso Del Junco.

SUPERVISOR'S NAME: Jazmond D Harris	TELEPHONE: (951) 212-0616
LICENSING EVALUATOR NAME: Kathleen Banrasavong	TELEPHONE: (951) 248-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024

LIC9099 (FAS) - (06/04)

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