Sierra Sunshine Care

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA's) Amy Rodgers and Letica Arroyo-Cervantes conducted an unannounced annual required visit to the above-mentioned facility. Upon arrival, LPA met with the Caregiver and was later joined by the Administrator.The facility operates as a Residential Care for the Elderly (RCFE) facility for individuals aged 60 and over and accepts Dementia residents. A facility tour was conducted, which included indoor activity areas, restrooms, kitchens, and outdoor space. All areas were clean, safe, and in good repair. Furniture and equipment were in good condition and appropriate for the clients in care. The facility has sufficient space and seating for all clients, with no exit obstructions. Restrooms were equipped with grab bars and adequate supplies. Hot water temperature measured within the required range.. Meals are prepared by staff, and menus were available at the time of visit. A random sample of client files was reviewed. Files contained current physicians’ reports, admission agreements, emergency information, needs and services plans, and other required documentation. Staff records reviewed contained criminal record clearance, health screening, current first aid/CPR certification, and required training. Supervision was observed to be appropriate, and staff were seen interacting with clients in a respectful and supportive manner. The facility’s emergency disaster plan was observed to be current and posted. Fire drills are conducted as required, and documentation is available for review. Fire extinguishers were serviced within the past year, and smoke/carbon monoxide detectors were operable. No deficiencies were cited during today’s visit. However, One (1) technical violation was noted during the visit. An exit interview was conducted with the Administrator, and a copy of this report, along with the Licensee Rights (LIC 9058), was provided to the Administrator. Her signature on this form confirms receipt of the documents.the state’s words, verbatim · CDSS document, Sep 11, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Renita Hall conducted an unannounced annual required visit to the above-mentioned facility. Upon arrival, LPA met with the Caregiver and was later joined by the Administrator. The facility operates as a Residential Care for the Elderly (RCFE) facility for individuals aged 60 and over and accepts Dementia residents. A facility tour was conducted, which included indoor activity areas, restrooms, kitchens, and outdoor space. All areas were clean, safe, and in good repair. Furniture and equipment were in good condition and appropriate for the clients in care. The facility has sufficient space and seating for all clients, with no exit obstructions. Restrooms were equipped with grab bars and adequate supplies. Hot water temperature measured within the required range of 105°F to 120°F. Meals are prepared by staff, and menus were available at the time of visit. A random sample of client files was reviewed. Files contained current physicians’ reports, admission agreements, emergency information, needs and services plans, and other required documentation. Staff records reviewed contained criminal record clearance, health screening, current first aid/CPR certification, and required training. Supervision was observed to be appropriate, and staff were seen interacting with clients in a respectful and supportive manner. LPA interviewed 2 staff and 0 clients; 4 were asleep in their rooms, and 1 in the living room did not engage with LPA. No concerns were noted. The facility’s emergency disaster plan was observed to be current and posted. Fire drills are conducted as required, and documentation is available for review. Fire extinguishers were serviced within the past year, and smoke/carbon monoxide detectors were operable. No deficiencies were cited during today’s visit. An exit interview was conducted with the Administrator, and a copy of this report, along with the Licensee Rights (LIC 9058), was provided to the Administrator. Her signature on this form confirms receipt of the documents.the state’s words, verbatim · CDSS document, Sep 26, 2025

Allegation investigated: - Licensee did not maintain internal temperatures comfortable for residents - Waste is overflowing in trash bins

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver investigation findings. While at the facility LPA investigated and delivered findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Gammel Jana, caregiver. LPA stated the purpose of the visit and reviewed the findings of the complaint with Administrator Cindy Chapari who later arrived to join the visit. The Department’s investigation consisted of interviews with staff and residents, and LPA observations of the facility grounds. On February 11, 2025, it was said that the medications are not being administered as prescribed; licensee did not maintain the facility temperatures comfortable for the residents; hot water is not regulated within the allotted temperatures; and Waste is overflowing in trash bins. Two of the allegations were delivered on 02/11/2025. It was specifically alleged that the facility heater is inoperable. During the visit, LPA conducted staff and resident interviews. Upon the resident interviews, R1 and R2 confirmed that the facility gets cold overnight. (Continuation on LIC9099-C) Unsubstantiated (Continuation of LIC9099) R1 said when they awake, the room temperature feels cool, but they put on their sweater, and they warm up. According to R2, the night was a little cooler than usual, but they had their sweater and a cover to keep them warm. Both R1 and R2 are unaware if the heater is operational and or if it may have issues with the internal temperature of the facility. Both R1 and R2 did not have any concerns with the internal temperatures. According to S1, the facility does have two systems in place. S1 said the back heater is inoperable. Upon LPA’s entrance to the facility, they observed the internal temperature to be at 64 degrees Fahrenheit (F) in the area where the residents reside during the visit on 2/11/25. At the entrance of the facility, LPA observed that the temperature was set at 70 degrees Fahrenheit. Both temperatures were within the ranges of regulation on 2/11/25. On 05/22/25 LPA observed both internal temperatures and the first read 73 degrees F and second read 65 degrees F. It was specifically alleged that the large waste bins were overflowing with waste. According to S1, they informed the Licensee that the facility needed an additional waste bin, as there was a lot of waste being thrown out daily. According to S2, both the recycling and waste bins would overflow. S2 said they would need to squeeze waste materials down the bin to ensure the trash company was able to collect all the waste. S2 said the owners had ordered the bins and were on their way. According to R1 and R2, they had no issues with their trash bins in their room since the staff takes it out daily. Upon the arrival of LPAs visit, on 2/11/25, LPA observed it was waste pick-up day and the bins were outside ready for pick-up. LPA observed the bin was full to the top with the lid of the bin slightly propped open with waste, but no waste fell out of the bin. During the visit on 5/22/25, LPA observed that the Licensee had ordered an additional waste bin, for a total of 2 waste bins, available for the facility. Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during staff and outside source interviews, records reviewed, and LPA observations, there is insufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be unsubstantiated. The report was discussed, and an exit interview was conducted with Administrator Cindy Chaparri. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to Administrator Chapari at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, May 22, 2025 · control 08-AS-20250211083051

Allegation investigated: - Staff not properly trained to attend to residents - Licensee installed auditory devices - Licensee did not provide the Department updates for facility cameras - Licensee did not notify the Department of facility alterations

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to deliver investigation findings. LPA identified herself and was granted entry by Gammel Jana, caregiver. LPA stated the purpose of the visit and reviewed the findings of the complaint with administrator Cindy Chapari. The Department’s investigation consisted of interviews with staff, residents, and outside sources, records review of relevant documents pertinent to this investigation, ad LPA observations. On January 22, 2025, it was said that staff were not properly trained to attend to residents, licensee installed audio devices, licensee did not provide updates for the facility camera’s, and licensee did not notify the Department of the facility alterations. (Continuation on LIC9099-C) Substantiated (Continuation of LIC9099) It was specifically said there were staff who are not being properly trained to assist residents in care. Interview with S1 and S2 said that they have been caregivers since about 2015. They had former training at their previous homes they worked, but according to S1, they had not received training at this facility. S1 said that former staff denied to train them and S2 when they first started. According to S2, they had a former certificates that expired and had no training for their current residents in care. S2 confirmed their CPR/First Aid were current. Upon LPA’s review of staff training documents, none of the training documents had been taken by any of the caregivers, S1 or S2. No additional training documents were observed in either of the facility’s staff files. It was specifically alleged that the Licensee did not inform the Department of the installation of the cameras and auditory devices throughout the facility. Interviews with staff confirmed that there were cameras installed at the facility when they initially visited the facility, but they were taken down. Both S1 and S2 were unaware whether the surveillance had an auditory device. According to S1, they were unsure if there were any auditory devices throughout the facility. Interview with R1 confirmed that there were cameras placed in the dining area and the living room area of the facility. They did not have any auditory devices installed in their immediate area. According to R2, they confirmed that they did have cameras at the facility and were not sure about them because it felt like a prison but were fine with it later. They were unaware if they had auditory devices. According to R3, there were cameras in the facility, but they had already been taken down. R3 did not recall when they were taken down. LPA spoke with Licensee Chapari, who confirmed that they had cameras installed but had been taken down due to an internal issue with a former staff. Licensee Chapari still had video clippings of their cameras and showed them to LPA. LPA confirmed that the video clippings had the auditory device installed with the surveillance. LPA toured the facility rooms and did not observe any additional devices auditory devices installed other than an third-party device that is voice activated in a residents room. Upon LPA’s review of the facility’s file, per the facility’s initial submission of their facility sketch, there is no indication that surveillance videos would be installed in the facility’s common areas. Upon review of the facility’s Plan of Operation, it did not indicate that the facility would be utilizing the use of cameras in any area of the facility. Upon review of the facility’s Admission Agreement, there was no indication that the facility provided notification that use of camera’s would be utilized at the facility. The Department had not received a waiver from the facility requesting to have surveillance installed. Upon LPA’s entrance to the facility, LPA observed that there were installations of a possible cameras that were installed in the dining area and in the living room area. (Continuation on LIC9099-C) (Continuation of LIC9099-C) It was specifically revealed the Licensee did not inform the Department of the alterations at the facility, which caused disruptions to the residents. According to S1, they spoke with the licensee who informed them that the caregivers will be staying in the newly built rooms that were constructed in the garage. According to R2, the rooms had been already completed when they arrived and only recently added the windows. Interview with R1 said there was construction in the garage and would hear the saws of the construction. The construction workers would work from about 3:30 PM through 8 or 9 PM, or until dark. According to R2, they were told about the construction, but that did not bother them. According to R3, the construction would start in the evenings. The strange thing was that the construction workers would go into the attic. Licensee Chapari confirmed that construction had been done from December 24, 2024 through this past weekend, January 25-26, 2025. According to the facility’s file, there was no indication that the Department had received information regarding the facility’s alteration. Upon LPA’s tour, the garage was remodeled to an office and a bedroom. The facility sketch on file did not have the rooms added to their garage. Based on the Department’s investigation of the above-mentioned allegation and the evidence obtained during staff and outside source interviews, records reviewed, and LPA observations, there is sufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be substantiated. California Code of Regulations, Title 22, Division 6, Chapter 8, is being cited on the attached LIC9099-D of this report. The report was discussed, plan of correction was jointly developed, and an exit interview was conducted with administrator Cindy Chapari. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to administrator Chapari at the conclusion of the visit. The signature below confirms the receipt of these documents. (Continuation of LIC9099-A) Interview with Staff #2 (S2) confirmed that both S1 and Staff #2 (S2) commenced their employment at the facility on 1/22/25. LPA was informed that they go by AKAs to make it easier for residents to call on them. LPA obtained S1 and S2’s full names and dates of birth. According to the Department records, both S1 and S2 are cleared staff and were associated with the facility before their start date at the facility. It was specifically alleged that staff had another staff person take their training to qualify for their training requirements. They said they had taken an online training and when the certificate was printed it said the name for Staff #3 (S3). According to S3, they did not have any staff take online courses for their requirements. They had taken their own requirements online recently. They provided LPA with their certifications which were dated between April 2025 and May 2025. They formerly had staff review their hard copied binder with caregiver training information. Once they completed the review, caregivers would need to take an exam at the end which was a hard copied exam. Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during resident, staff and outside source interviews, and records reviewed, there is insufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be unsubstantiated. The report was discussed, and an exit interview was conducted with administrator Cindy Chapari. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to administrator Chapari at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, May 22, 2025 · control 08-AS-20250122154838

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87412(c) · Plan of correction due date: Jun 23, 2025

87412 Personnel Records: (c) Licensees shall maintain in the personnel records verification of required staff training and orientation... This requirement was not met as evidence by: Based on records review and interviews, the licensee did not have training for staff caring for 4 of 4 residents in care which posed a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 22, 2025

Plan of correction: Administrator agreed to obtain training records for 4 of 4 current staff and submit them to LPA by POC due date, 6/23/25

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Jun 6, 2025

87468.1 Personal Rights of Residents in all Facilities: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. Based on interview and observations, the licensee did have auditory voice installed with their surveillance footage in the common areas for 4 of 4 residents in care which posed a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 22, 2025

Plan of correction: This was cleared during the visit as the auditory devices were uninstalled. This allegation is deemed cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(2) · Plan of correction due date: Jun 6, 2025

87468.1 Personal Rights of Residents in all Facilities: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. Based on interview and observations, the licensee did not notify the Department of the camera(s) being installed for 4 of 4 residents in care which posed a potential personal rights risk to residents in care.the state’s words, verbatim · CDSS document, May 22, 2025

Plan of correction: This was cleared during the visit as the camera devices were uninstalled. This allegation is deemed cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87305(b) · Plan of correction due date: May 30, 2025

87305 Alterations to Existiing Building or New Facilities: (b) The licensing agency may require the facility to acquire a local building inspection where the agency determines that a suspected hazard to health and safety exists... this requirement was not met as evidence by: Based on interview, records review and observations, the licensee did not notify the Department of the alterations being constructed in the facility garage which posed a potential safety risk to 4 of 4 residents in care.the state’s words, verbatim · CDSS document, May 22, 2025

Plan of correction: Administrator agreed to update their faciliity sketch to LPA and the RO by POC due date, 5/30/25.

Type of visit: POC

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced case management visit for a Plan of Correction clearance. LPA Lopez identified herself and was allowed entry by caregiver, Gammel Jana. LPA met with Administrator Cindy Chapari and discussed the purpose of the visit. On 02/22/2025, the facility was issued a deficiency for electrical equipment defects. During today’s visit, LPA tested the electrical outlets and ensured that there were not defects when connecting a device. On 02/11/2025, the facility was also issued a deficiency for medication not being administered as prescribed. During today’s visit, LPA review the medications, and the facility had removed the pill boxes and medications are now being packaged by their respective pharmacy. The facility was also cited for water being too high per regulation. LPA checked the hot water and was within the allotted temperature per regulation. As such, the deficiencies have been corrected and are deemed cleared. No additional deficiencies were observed during this case management visit. An exit interview was conducted and a copy of this report along with Licensee Rights (LIC 9058 03/22) were provided to Administrator Chapari at the conclusion of the visit. The signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, May 22, 2025

Allegation investigated: - Medications are not being administered as prescribed - Hot water is not regulated within the allotted temperatures

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit to open a complaint investigation. While at the facility LPA investigated and delivered two findings regarding the above-mentioned allegations. LPA identified herself and was granted entry by Pouya “Paul” Ghorbanpour, caregiver. LPA stated the purpose of the visit and reviewed the basic elements of the visit with caregiver Ghorbanpour. The findings of the complaint were delivered to licensee Shawn Chapari and administrator Cindy Chapari. The Department’s investigation consisted of interviews with staff and residents, and LPA observations of the facility grounds. On February 10, 2025, it was said that the medications are not being administered as prescribed and hot water is not regulated within the allotted temperatures. It was specifically said that the residents’ medications were not in their original containers. On January 29, 2025, during an unrelated visit, LPA observed that medications were being dispensed via pill box. LPA spoke with both the licensee Chapari and administrator Chapari regarding medications being dispensed from their original container. Both agreed to dispense their medications by their proper container. (Continuation on LIC9099-C) Substantiated (Continuation of LIC9099) On February 11, 2025, LPA toured the facility and requested to observe their medication cabinet. Upon the review of their medications, LPA observed that the facility dispensed their medications for the entire week in their respective pill box. Upon staff interviews, both staff #1 (S1) and staff #2 (S2) confirmed that they use the pillboxes to dispense medications. According to S1, they were directed to continue to place the medications in the pill box by their administrator on January 30, 2025. Based on the information obtained, there is sufficient evidence to meet the preponderance of evidence standard. It was said that the hot water temperatures are too high. During the tour of the facility, LPA was able to measure the hot water temperatures of the three bathrooms and the kitchen. The hot water temperatures read as follows: bathroom #1 measured hot water temperature at 120.7 degrees Fahrenheit; bathroom #2 measured hot water temperature at 119.7 degrees Fahrenheit; bathroom #3 measured hot water temperature at 121.3 degrees Fahrenheit; and kitchen sink measured hot water at 121.3 degrees Fahrenheit. The kitchen sink did have a sign on the faucet that read “water very hot.” Based on the evidence obtained, there is sufficient evidence to meet the preponderance of evidence standard. Based on the Department’s investigation of the above-mentioned allegations and the evidence obtained during staff and resident interviews, and LPA observations, there is sufficient evidence to meet the preponderance of evidence standard. Therefore, the above allegations are deemed to be substantiated. California Code of Regulations, Title 22, Division 6, Chapter 8, is being cited on the attached LIC9099-D page of this report. The report was discussed, plan of correction was jointly developed, and an exit interview was conducted with licensee Shawn Chapari and administrator Cindy Chapari. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to Licensee Chapari at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, Feb 11, 2025 · control 08-AS-20250211083051

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(5) · Plan of correction due date: Feb 21, 2025

Incidental Medical and Dental Care (h)(5) Each resident's medication shall be stored in its originally received container. No medications shall be transferred between containers...This requirement was not met as evidence by: Based on LPA observations, facility did not store residents medication in its original container. This posed a potential health risk to 3 of 4 residents in care.the state’s words, verbatim · CDSS document, Feb 11, 2025

Plan of correction: Administrator will be placing the residents medications back to their original containers and removing the pill boxes and inform LPA by POC due date, 02/21/2025.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87303(e)(2) · Plan of correction due date: Feb 26, 2025

(2) Faucets used by residents for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement was not met as evidence by: Based on LPA observations, facility did not ensure that hot water at taps were within the allotted measures. This posed a potential health risk to 3 of 4 residents in care.the state’s words, verbatim · CDSS document, Feb 11, 2025

Plan of correction: Licensee will be lowering the hot water temperature and maintain a log for 2 weeks and submit the logs to LPA by POC due date, 02/26/2025.

The state marks this report as 4 pages; the online copy we transcribed has 3. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced complaint visit and in conjunction conducted this case management for issues identified while conducting today’s visit. LPA Lopez identified herself and was granted entry by caregiver Pouya “Paul” Ghorbanpour and explained the purpose of the visit. LPA met with licensee Shawn Chapari and administrator Cindy Chapari who later arrived and joined the visit. During LPA’s tour of the facility, LPA spoke with residents. Resident #1 (R1) had mentioned during their interview, that some outlets throughout the facility had shorts. During the interview, LPA was granted permission by R1 to plug in a charger. LPA observed that the outlet did have a short, as the outlet sparked when LPA plugged in the charger. During further interviews it was discovered that resident #2 (R2) had medication in their drawer provided by their family. LPA observed that R2 did in fact have 2 medications in their drawer to assist with their bowel. Both medications were new and were unopened. Deficiencies were observed and cited during today's visit and can be reviewed on the attached LIC809-D page of this report. The report was discussed, plan of correction was jointly developed, and an exit interview was conducted with licensee Shawn Chapari and administrator Cindy Chapari. A copy of this report along with Licensee/Appeal Rights (LIC9058 3/22) were provided to licensee Chapari at the conclusion of the visit. The signature below confirms the receipt of these documents.the state’s words, verbatim · CDSS document, Feb 11, 2025

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87465(h)(2) · Plan of correction due date: Feb 11, 2025

87465 Incidental Medical and Dental Care (h)(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for the supervision of the centrally stored medication. This requirement was not met as evidence by: Based on LPA observations and interviews, facility did not centrally store the residents medication in a safe and locked location. This posed a potential health risk to 1 of 4 residents in care.the state’s words, verbatim · CDSS document, Feb 11, 2025

Plan of correction: Licensee and administrator removed the medications from the residents room during the visit. POC is deemed cleared.

From the deficiency page — Deficiency type: Type B · Section cited: CCR80075(e)(2)(D) · Plan of correction due date: Mar 12, 2025

80075 Health Related Services (e)(2) (D) All electrical equipment is checked for defects that may cause sparks… This requirement was not met as evidence by: Based on LPA observations and interviews, facility did not ensure that the electrical outlets had no defects. This posed a potential safety risk to 1 of 4 residents in care.the state’s words, verbatim · CDSS document, Feb 11, 2025

Plan of correction: Licensee agreed to ensure that the electrical outlets are checked and the defects are corrected and inform LPA by POC due date, 03/12/2025.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced Required 1 year Annual Visit. LPA was allowed entry by Cindy Chapari, Licensee. LPA identified herself and disclosed the purpose of the visit with the Licensee. The facility does not have residents at this time census is zero (0). Physical Environment: The facility was found to be clean, well-maintained, and free from any safety hazards. Adequate lighting and ventilation were observed in all areas of the facility. All necessary safety equipment, such as fire extinguishers and emergency exits, were present and in good working condition. The facility's outdoor spaces were properly maintained. Overall, the facility was found to comply with the licensing regulations. An exit interview was conducted and a copy of this report along with the Licensee Rights (LIC 9058) was provided to Cindy Chapari. Her signature on this form confirms receipt of the documents.the state’s words, verbatim · CDSS document, Sep 18, 2024