374603394-2-5-2021-08-AS-DPOL-BYGTKN-20210222134814

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603394
Report Date: 01/21/2021
Date Signed: 02/05/2021 05:07:39 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2020 and conducted by Evaluator Jonathan C Pineda

COMPLAINT CONTROL NUMBER: 08-AS-20200625162252

FACILITY NAME:	SUNRISE ASSISTED LIVING AT BONITA		FACILITY NUMBER:	374603394
ADMINISTRATOR:	GOODING, ROXANNE		FACILITY TYPE:	740
ADDRESS:	3302 BONITA RD		TELEPHONE:	(619) 470-2220
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	96	CENSUS: 51	DATE:	01/21/2021
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Roxanne Gooding, Administrator		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Staff did not provide assistance to resident
Facility did not maintain a comfortable temperature for client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jonathan Pineda conducted an unannounced complaint tele-visit to deliver findings on the above allegations. LPA identified himself and stated the purpose of the visit. LPA spoke with Roxanne Gooding, Administrator.

The Department's investigation consisted of a tour of the facility, observations, interviews with staff, resident, outside sources, and a review of resident records.

It was alleged that facility staff did not not provide assistance to resident. Investigation revealed that Resident 1’s, R1’s (See confidential names list) room was located on the first floor. Interview from an outside source revealed a request was submitted to relocate R1 to a different room. R1 was moved on June 17, 2020. Investigation revealed facility staff moved R1’s furniture, hung R1’s pictures up and moved other large items.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Jonathan C Pineda	TELEPHONE: (619) 481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

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 08-AS-20200625162252

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SUNRISE ASSISTED LIVING AT BONITA	FACILITY NUMBER: 374603394
	VISIT DATE: 01/21/2021

NARRATIVE

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Facility staff also moved R1’s personal belongings and all items were put back exactly as they were in their previous room within two hours. Interview revealed that facility staff provided R1 assistance such as hanging their pictures and moving their personal belongings in a timely manner when R1 was moved to their new room. R1 advised that facility staff is always helpful and kind. Interview with an outside source revealed that there were no concerns regarding R1’s move to their new room and they observed facility staff to be very kind and are satisfied with their services.

It was alleged that facility did not maintain a comfortable temperature for client in care. Interview with R1 revealed that the temperature maintained in their room is comfortable and that facility staff always are attentive to their needs if the temperature needs to be adjusted. R1 stated that they don't recall facility staff throwing them a jacket when they said they were cold. Interview with an outside source revealed that they have never observed an uncomfortable temperature in R1’s room. LPA observation revealed thermostat in R1’s room to be set at 75 degrees.

The Department investigated the allegations that staff did not provide assistance to resident and facility did not maintain a comfortable temperature for client in care.

Based on observations, review of records, interviews, and outside sources, it is determined that the allegations are UNSUBSTANTIATED. There is not a preponderance of the evidence to prove the allegations occurred.

An exit interview was conducted with Roxanne Gooding, Administrator. A copy of this report, LIC-9099 and Licensee Rights (9058 01/16) were left with the Licensee, whose signature on this form confirm receipt of these documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (610) 301-9770
LICENSING EVALUATOR NAME: Jonathan C Pineda	TELEPHONE: (619) 481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

LIC9099 (FAS) - (06/04)

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