374603793-10-27-2021-08-AS-IESA-C9A4FG-20211130180355

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603793
Report Date: 10/26/2021
Date Signed: 10/27/2021 08:50:27 AM

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
10/20/2021 and conducted by Evaluator Natasha Persaud

COMPLAINT CONTROL NUMBER: 08-AS-20211020163547

FACILITY NAME:	SUNRISE OF SABRE SPRINGS		FACILITY NUMBER:	374603793
ADMINISTRATOR:	JESSICA ZEPEDA		FACILITY TYPE:	740
ADDRESS:	12515 SPRINGHURST DR		TELEPHONE:	(858) 391-9160
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92128
CAPACITY:	100	CENSUS: 89	DATE:	10/26/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Executive Director, Jessica Zepeda		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Residents are not provided adequate food service

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Natasha Persaud conducted an unannounced visit to commence a complaint investigation. LPA identified herself and discussed the allegation mentioned above with Executive Director (ED), Jessica Zepeda.

During today's visit, LPA briefly toured the facility, requested records, and interviewed staff and residents. It was alleged some residents are not receiving all their daily meals due to room service not being provided. The facility's staff have an IPad they carry with them to take food orders for residents that do not want to have their meals in the dining room. ED explained a lot of residents became accustom to eating in their rooms during the pandemic. However, dining has been back to normal for months but some residents continue to eat in their rooms. ED explained they are encouraging the residents to dine together for the social aspect. Residents that prefer room service instead of going to the dining room are charged an additional cost for room service. For the residents that prefer to eat in their room, facility staff enter the residents food order into an IPad. Continued on the LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

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-20211020163547

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 OF SABRE SPRINGS	FACILITY NUMBER: 374603793
	VISIT DATE: 10/26/2021

NARRATIVE

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The orders are sent directly to the kitchen via IPad. Ticket orders are then printed and placed with the food items ordered. The food tray is then delivered to the resident's room with all requested items. The IPad reflects a green check mark by the resident's name once their food is ordered, if the resident doesn't place an order, the item shows an order was not placed. Facility staff explained if they observe a resident did not place a food order, they will check in with the resident. After checking in with the resident regarding why a meal order was not placed, they may discover the resident was out of the community or had other meal plans. The facility's documentation reflected meals are ordered and delivered, and for the orders that are not placed, there is a reason listed. Resident interviews confirmed they are receiving room service for all meals requested. Residents stated sometimes they want room service for breakfast but prefer to eat in the dining room for lunch and dinner, it does not mean they were not provided meals since they did not order room service. Staff interviews revealed they check on the residents to ensure they received their meals or obtain a reason for meals not being ordered. Additional staff interviews revealed the staff will check on the resident within one (1) hour of the food being delivered to ensure the resident received their room service. Based on record review and interviews conducted we are unable to confirm or deny if residents are not provided adequate food service. Investigation revealed inconsistent statements and information obtained did not present a preponderance of evidence to support or corroborate the allegation. Therefore, the allegation is deemed unsubstantiated.

An exit interview was conducted with Executive Director, and a copy of this report, along with Licensee/Appeal Rights (LIC 9058 01/16), were provided to the Executive Director, via electronic mail. An electronic read receipt confirmation was requested to be sent by the Executive Director, upon receipt of the documents.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Natasha Persaud	TELEPHONE: (619) 301-3594
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2021

LIC9099 (FAS) - (06/04)

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