374603793-5-15-2023-08-AS-DPOL-CSCTJL-20230531144630

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374603793
Report Date: 05/15/2023
Date Signed: 05/15/2023 05:39:18 PM

Unfounded

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
04/19/2023 and conducted by Evaluator Marisela Garcia-Centeno

COMPLAINT CONTROL NUMBER: 08-AS-20230419130153

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: 75	DATE:	05/15/2023
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Assisted Living Coordinator, Sandra Anderson		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff falsifying documents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted an unannounced visit to deliver investigative findings on the above allegation. LPA identified herself and met with Assisted Living Coordinator, Sandra Anderson to discuss the purpose of the visit.

The Department investigated the complaint allegation. The investigation consisted of a tour of the facility, multiple interviews with staff and outside sources, and detailed review of the Electronic Medication Administration Records System (EMARS).

On April 9, 2023, Community Care Licensing (CCL) received a complaint alleging that facility staff falsified medication documents. It was specifically alleged that facility staff administered medication late on April 16 and 17, 2023, and changed the actual time and date of when the medication was actually given to the residents.
(Continue on LIC9099C)

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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-20230419130153

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: 05/15/2023

NARRATIVE

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(Continue from LIC9099)

On April 26, 2023, a detailed review of the EMARS audit reports for three clients indicated that although the medications were administered late, the correct date and time were automatically recorded in the EMARS. The date and time are automatically generated by the EMARS at the time of administration. Although the EMARS allowed staff to administer medication late, staff were not able to enter a different date/time or change this information in anyway. The date/time fields were not editable in the EMARS. The audit trail was controlled by internal systems controls inherently programmed in the EMARS.

Review of 4/16/2023 and 4/17/2023 EMARS audit reports for three randomly selected residents did not provide any evidence that staff falsified the EMARS with incorrect date/time of when medications were administered. During interviews, staff denied allegation.

Based on observations, review of pertinent records and interviews with staff there was no evidence found to support this allegation. The Department has found that the complaint allegation was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted with Assisted Living Coordinator, Sandra Anderson, to whom a copy of this report, and Licensee Appeal Rights (9058 01/16) were provided at the conclusion of the visit.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Marisela Garcia-Centeno	TELEPHONE: (619) 323-4834
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC9099 (FAS) - (06/04)

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