Sunny View Retirement Community

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced case management visit to follow up on the case management visit conducted on 04/07/2026 and 05/07/2026. LPA Rai met with Health Services Director, Rubina Banwait and stated the purpose of today's visit. On 04/01/2026, the Department received a report regarding two residents at the facility. Per report, it was reported on behalf of resident R1's family that resident R1 was being abused by resident R2 at the facility. On 04/07/2026, LPA Rai conducted a visit to follow up on the report received on 04/01/2026. LPA Rai interviewed Administrator (ADM) Bradley Burgoyne and Director of Health Services (DHS) Adriana De La O. ADM stated they spoke with resident R1 and R2 and both residents reported there are no concerns of abuse. DHS has checked in with resident R1 multiple times since the incident was reported and resident R1 has not reported any health, safety or personal rights concerns. ADM and DHS stated they will continue to supervise both resident R1 and R2 and ensure the health, safety and personal rights risks are addressed. LPA Rai was not able to interview resident R1 and resident R2. On 05/07/2026, LPA Rai conducted a visit to follow up and LPA Rai was not able to interview R1 & R2 as resident were out of the community and did not want to speak with LPA Rai. During today's visit, LPA Rai interviewed resident R1. R1 stated he/she was safe at the facility and they were not abused by residents or staff at the facility. R1 is aware of their Personal Rights and they are aware they can inform the facility staff if they have any concerns about their safety in the facility. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. The Department has completed the investigation of the above incident. The Department has found that the allegation of resident being abused at the facility and staff are not addressing resident's abuse, as UNFOUNDED, meaning that the allegation were false, could not have happened and/or are without a reasonable basis. No deficiencies were cited at this time as per California Code of Regulations, Title 22. This report was reviewed with Health Services Director, Rubina Banwait and a copy of this report was provided.the state’s words, verbatim · CDSS document, Aug 12, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Administrator (ADM) Bradley Burgoyne and Director of Health Services (DHS) Adriana De La O and stated the purpose of today's visit. During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured the facility to include but not limited to at random 5 resident rooms, common areas, dining room and kitchen. 5 Out of 5 resident bedrooms had available bedding, drawers, and functioning lights. The resident bathroom had available soap, paper towels, and trash cans with lids. The hot water temperature in the bathroom sinks ranged from 114.2 - 117.8 degrees F. Fire extinguisher was observed and inspected on 03/05/2026. Facility smoke detectors and sprinkler system was inspected by third party vendor on 03/11/2026 & 02/27/2026 and the reports stated the inspection was passed. The last disaster drills were conducted on 04/27/2026 & 03/05/2026. LPA Rai observed a complete first aid kit at the facility. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. LPA Rai reviewed facility records for 10 staff and 10 residents. LPA Rai reviewed at random 5 residents' medications and central stored medication records. No deficiencies were cited per California Code of Regulations, Title 22. This report was reviewed with Director of Health Services (DHS) Adriana De La O and a copy of the report was provided. LIC 858 and LIC 859 were provided.the state’s words, verbatim · CDSS document, May 21, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst Simi Rai conducted an unannounced case management to follow up on an report submitted by the facility to the Department on 04/01/2026 and visit was conducted on 04/07/2026. LPA met with Administrator (ADM) Bradley Burgoyne explained the purpose of the visit. On 04/01/2026, the Department received a report regarding two residents at the facility. Per report, it was reported on behalf of resident R1's family that resident R1 was being abused by resident R2 at the facility. During today's visit, LPA Rai interviewed Administrator (ADM) Bradley Burgoyne. ADM stated they had a meeting with both Resident R1 & R2 as well as their responsible parties. ADM stated the facility staff will continue to check in with the residents and continue to ensure resident's Personal Rights are not violated. During today's visit, LPA Rai was not able to interview R1 & R2 as resident were out of the community and did not want to speak with LPA Rai. At this time, this case in under review and the Department will conduct a follow up visit, if warranted. No deficiencies were cited during today's case management visit and copy of the report was provided.the state’s words, verbatim · CDSS document, May 7, 2026

Type of visit: Case Management - Incident

Licensing Program Analyst Simi Rai conducted an unannounced case management to follow up on an report submitted by the facility to the Department on 04/01/2026. LPA met with Administrator Bradley Burgoyne explained the purpose of the visit. On 04/01/2026, the Department received a report regarding two residents at the facility. Per report, it was reported on behalf of resident R1's family that resident R1 was being abused by resident R2 at the facility. During today's visit, LPA Rai interviewed Administrator (ADM) Bradley Burgoyne and Director of Health Services (DHS) Adriana De La O. ADM stated they spoke with resident R1 and R2 and both residents reported there are no concerns of abuse. DHS has checked in with resident R1 multiple times since the incident was reported and resident R1 has not reported any health, safety or personal rights concerns. ADM and DHS stated they will continue to supervise both resident R1 and R2 and ensure the health, safety and personal rights risks are addressed. During today's visit, LPA Rai obtained the following documents but not limited to R1 & R2's Physician's Report and R1's Appraisal/Needs and Services Plan. At this time, this case in under review and the Department will conduct a follow up visit, if warranted. No deficiencies were cited during today's case management visit and copy of the report was provided.the state’s words, verbatim · CDSS document, Apr 7, 2026

Allegation investigated: Facility staff is not addressing resident's right to be free from emotional and sexual abuse.

Licensing Program Analyst (LPA) Manuel Monter conducted an unannounced visit to conclude the complaint investigation. LPA met with the Director of Health Services Adriana Delao and stated the purpose of today’s visit. On January 3, 2025, the Department received a complaint with the above allegation. On January 7, 2025, the Department conducted an initial investigation at the facility. It was alleged that the facility staff are not addressing resident R1 from receiving emotional and sexual abuse from another resident R2. Page 1 Out of 3. Unsubstantiated On January 7, 2025, the Department interviewed 3 staff (S1-S3). 3 out of 3 staff (S1-S3) stated they have not seen or heard of resident R2 emotionally or sexually abusing resident R1. 3 out of 3 staff (S1-S3) stated the facility staff will observe R1 and R2 in the common areas, such as the front lobby or dining room and they have not seen the residents upset or have concerns about abuse. 3 out of 3 staff (S1-S3) stated R1 is supervised 24 hours/7 days a week with a 1:1 companion in addition to facility staff conducting safety checks. 3 out of 3 staff (S1-S3) stated R1 has not brought up any concerns to facility staff. S2 stated they personally asked R1 if R2 has been emotional and/or sexually abusing the resident and R1 has refused the allegations. LPA Rai interviewed Administrator (ADM) Bradley Burgoyne. ADM stated R1 and R2 are friends and spend time with each other. ADM stated R1 is capable of making his/her own decisions and wants to hand out with R2. ADM stated R1 has a 1 on 1 care giver, so any instances where they come into contact would be supervised. On 8/22/2025, LPA Rai interviewed R1. R1 stated the emotional and sexual abuse allegations are false. R1 stated he/she feels safe in the community. R1 stated staff and residents, including R2, are not emotional or sexually abusing him/her. R1 stated he/she does not know how the allegations are true when R1 is fond of R2 and feels safe with R2. On September 12 and 23, 2025, LPA Monter interviewed residents R1-R8. 5 Out of 8 residents, (R1, R4, R5, R6, R7) stated they haven’t seen or heard residents speaking to each other in a negative or inappropriate way. R2 stated he/she hasn’t heard any inappropriate comments being made to other residents. R2 stated he/she has heard residents making mean comments, like saying “here comes trouble.” R2 stated in response he/she will make a mean comment back, regarding his/her weight. R3 stated R2 will make inappropriate comments to R3, but in response, R3 will make inappropriate comments to R2. R8 stated he/she hasn’t heard any inappropriate comments from residents or resident R2. R8 stated he/she heard that R2 was bossing around R1, but he/she didn’t witness this event. Page 2 Out of 3. 5 Out of 8 residents interviewed, (R1, R4, R5, R6, R7) stated they haven’t seen or heard residents touching other residents in an inappropriate manner. R2 stated he/she doesn’t touch other residents without their consent. R2 stated he/she hasn’t seen other residents who touch others in inappropriate manner. R3 stated he/she hasn’t personally seen R2 put arms around a resident/ touching resident, making them feel uncomfortable. R3 stated he/she has heard about this from other residents. R8 stated in terms of the inappropriateness, R2 will sometimes put his/her arm around you. On September 12 and 23, 2025, LPA Monter interviewed staff S4-S10. 7 Out of 7 Staff interviewed stated they haven’t seen residents speaking or touching other residents in an inappropriate manner. Based on review of R1 and R2’s facility file, there are zero incidents reported regarding R1 and R2 being involved in sexual/emotional/physical abuse. Based on investigation, records reviewed, and interviews conducted, the Department found that the above allegations are UNSUBSTANTIATED. An unsubstantiated finding indicates that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegations did or did not occur. No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with Director of Health Services Adriana Delao and a copy of the report was provided.the state’s words, verbatim · CDSS document, Sep 30, 2025 · control 26-AS-20250103091538

Type of visit: Case Management - Other

Licensing Program Analyst Manuel Monter conducted an unannounced case management to amend a Complaint investigation, LIC9099 and LIC9099-D issued on August 22, 2025. LPA met with Administrator Bradley Burgoyne explained the purpose of the visit. The complaint investigation closed on August 22, 2025 is being amended and re-opened due to new information provided to the Department. No deficiencies cited during todays visit. This Report was reviewed with Administrator Bradley Burgoyne. A signed copy was provided.the state’s words, verbatim · CDSS document, Sep 12, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced continuation of the Required 1 Year visit from 5/30/2025. LPA Rai met with Executive Director, Bradley Burgoyne and stated the purpose of today's visit. During visit, LPA Rai toured the inside and outside of the facility. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai toured the facility to include 5 resident rooms, dining room, activity room, kitchen and memory care unit. 5 Out of 5 resident bedrooms had available bedding, drawers, and functioning lights. The facility bathroom had available soap, paper towels, and trash cans with lids. The hot water temperature in the bathroom sinks ranged from 111.6 - 113.7 degrees F. LPA Rai observed 1 prescription medication located in the bathroom mirror cabinet wall mounted above the sink in Resident R5's Room. Staff (S1) stated the medication should not be present in R5's room and R5's medications should be locked and inaccessible to resident. Based on review of R1's LIC 602A Physician's Report 3/6/2025, R1 has neurocognitive disorder and R1 is not able to administer own prescription medications, and not able to store own medications. Continuation on LIC 809-C, Page 1 of 2. Page 2 of 2. Facility smoke detectors, sprinkler system and delayed egress doors were inspected by a third party vendor on 10/15/2024. The last disaster drills were conducted on 2/28/2025 and 3/5/2025. LPA Rai reviewed resident medications and central stored medication records. Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment. LPA Rai informed Executive Director, Bradley Burgoyne about the Department’s Technical Support Program (TSP) and provided the website: Community Care Licensing Division (CCLD) website www.cdss.ca.gov. LPA Rai requested an updated LIC 500 to update the information on the current Administrator as Bradley Burgoyne. Executive Director agreed and understood. This report was reviewed with Executive Director, Bradley Burgoyne. A copy of the report was provided. Appeal Rights were provided.the state’s words, verbatim · CDSS document, Jun 6, 2025

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(h)(2) · Plan of correction due date: Jun 7, 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 is not met as evidenced by: Based on observation and record review, Resident R5's prescription medication were accessible to R5 in the bathroom cabinet wherein R5 is not able to store or administer their own medication which poses/posed an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, Jun 6, 2025

Plan of correction: Executive Director stated to submit a written plan of action understanding regulation and will ensure in-service training is provided to staff responsible for administrating medication by POC due date. Executive Director agreed and understood.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit. LPA Rai met with Director of Health Services, Adriana De La O and stated the purpose of today's visit. During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. Fire extinguisher was observed and inspected on 03/07/2025. LPA Rai reviewed facility records for 5 staff and 5 residents. LPA Rai will return another day to complete annual inspection. This report was reviewed with Director of Health Services, Adriana De La O and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 30, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Simi Rai arrived unannounced to conduct a continuation of the annual inspection from 5/22/2024 and met with Director of Health Services, Adriana De La O and Administrator Ryan Golze. During today's visit, LPA Rai continued to review 10 resident files and 8 staff files. LPA Rai reviewed at random resident's Centrally Stored Medication Log and centrally stored medications in the Medroom. LPA Rai reviewed Resident #11's medication #1 the number of tablets in the bottle did not match the Central Stored Medication Record. Medication #1 should have 149 tablets in the bottle, LPA and Director of Health Services, Adriana De La O observed 155 tablets, which meant there were 6 extra tablets in the bottle. LPA Rai re-counted the medication with Staff S1 as well and the medication count in the bottle was 155. 87411 Personnel Requirements - General is being cited during today's visit. LPA Rai would like to clarify the facility personnel being in sufficient in numbers is not the concern, however the facility personnel's actions and documentation observed in Medroom are not competent to provide the services necessary to meet the resident's needs. Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. This report was reviewed with Director of Health Services, Adriana De La O and Administrator Ryan Golze. A copy of the report was provided. Appeal Rights were provided.the state’s words, verbatim · CDSS document, May 24, 2024

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87411(a) · Plan of correction due date: May 25, 2024

87411 Personnel Requirements - General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by: Based on record review, interview and observation R11's medication #1 was not administered to R11 which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, May 24, 2024

Plan of correction: Administrator stated to submit a written plan on understanding regulations, ensure staff administer medication as prescribed by the physician and schedule in-services training by POC date. Administrator agreed and understood.

From the deficiency page — Deficiency type: Type A · Section cited: CCR87207 · Plan of correction due date: May 25, 2024

87207 False Claims No licensee, officer or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility. This requirement is not met as evidenced by: Based on record review, interview and observation, R11's MARs noted medications administered but 6 addititonal tablets were in medication bottle, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.the state’s words, verbatim · CDSS document, May 24, 2024

Plan of correction: Administrator stated to submit a written plan on understanding regulations, ensure staff administer medication as prescribed by the physician and schedule in-services training by POC date. Administrator agreed and understood.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced Required 1 Year visit and met with Administrator, Ryan Golze and Director of Health Services, Adriana De La O and stated the purpose of today's visit. During visit, LPA Rai toured the inside and outside of the facility. When touring the outside area of the facility, the exits were cleared of obstruction. LPA Rai toured the facility kitchen and observed food supply of at least 2 days of perishable food and at least 7 days of nonperishable food. Sharps and medications were locked in secured areas. LPA observed additional food supply areas and secured areas for cleaning supplies and laundry detergents. LPA Rai randomly toured 10 resident bedrooms. 10 out of 10 resident bedrooms had available bedding, drawers, and functioning lights. The resident bathrooms had available soap, paper towels, and trash cans with lids. The water temperature in the bathroom sinks ranged from 109.6 degrees F - 113.1 degrees F. Fire extinguisher was observed and inspected on 3/5/2024. Facility fire system was inspected by third party vendor on 3/11/2024. Facility fire sprinklers were inspected by third party vendor on 3/7/2024. Facility had 1 carbon monoxide detector next to the gas fireplace and the detector was in working condition. The last disaster drill was conducted on 5/6/2024. LPA Rai will return another day to complete annual inspection. This report was reviewed with Administrator, Ryan Golze and Director of Health Services, Adriana De La O and a copy of the report was provided.the state’s words, verbatim · CDSS document, May 22, 2024

Allegation investigated: Facility did not ensure resident safety, resulting in resident sustaining an injury.

Licensing Program Analyst (LPA) Simi Rai conducted an unannounced visit to conclude the complaint investigation. LPA Rai met with LVN Residential Manager, Fidel Manuel and stated the purpose of the visit. On 8/10/2023, the Department received a complaint regarding facility not ensuring resident’s safety which resulting in resident sustaining an injury. On 8/7/2023 at about 6am, resident (R1) was found in the bedroom with half his/her body hanging off of the bed and leaning on his/her right side. R1 was repositioned and per staff, R1 did not complain of pain. Around “lunch time” same day, R1 was sliding towards the edge of his/her wheelchair in the activity room. When staff repositioned R1 on the wheelchair, R1 sustained a skin tear on the right wrist. At that time, R1 complained of leg pain to the staff and facility sent R1 to the hospital around 1:45pm. Continuation on LIC 9099-C, Page 1 of 3. Unsubstantiated Page 2 of 3. On 8/7/2023, from about 2am - 6am, R1 had 2 (two) unwitnessed falls in his/her room, where R1 was found on the floor or sliding off the bed. On 8/14/2023, the Department received an Incident Report dated 8/7/2023, stating at about 6:00am staff observed half of R1’s body hanging off the bed, leaning on the right side. R1 was repositioned in bed and R1 did not have any pain. On 8/21/2023, the Department received an addendum to the Incident Report for 8/7/2023 stating R1 was observed at about 2:00am on the floor next to his/her bed in a sitting position during safety check rounds. Staff did not observe any injury and 2 staff assisted R1 back to bed. Report stated staff did not document the incident and the facility conducted in-service training on 8/19/2023. Based on record review of R1’s file, R1 has a history of falls which have been sustained before and after being admitted to the facility. Based on Physician’s Report dated 6/17/2022, R1’s other conditions were listed as “repeat falls” per physician’s notes. R1’s Services Plan dated 5/10/2023, R1 had a history of 9 falls within the year 2022 and episodes of increased confusion, hallucinations, and weakness. R1 requires daily dress/undressing, bathroom twice a week, routine bathroom assistance, and wheelchair escort. The Services Plan does not address R1’s fall-risk behaviors. Based on interviews conducted on 8/16/2023 with 4 staff (S1-S4), 4 out of 4 staff stated R1 had a history of falls and needed 2 person assistance for Activities of Daily Living (ADL), which included bathing, dressing, and toileting. 4 out of 4 staff stated R1 needs bed rails to help assist with falls. Based on an interview with Resident Services Director (RSD) on 8/17/2023, R1 did not need fall prevention precautions but R1 would benefit from them. Per RSD, R1 used a half-bed rail and R1 is on 2-hour safety checks conducted by staff. After the incident occurred on 8/7/2023, R1 was admitted to the hospital from 8/7/2023 through 8/11/2023. Based on R1’s hospital notes, the reports stated the hospital conducted X-rays of R1's knees and ankles. The impressions of the knee discovered a “comminuted distal femur fracture above the right knee prosthesis. The impression of the ankles were “chronic appearing and severe degenerative changes throughout the ankle. No gross fracture”. Per discussion of the hospital physicians, based R1's advance dementia and prior low level of function, surgery was not appropriate. Based on review of R1’s interdisciplinary Notes, R1’s responsible party updated facility of R1’s condition, stated R1 sustained a fracture in R1’s knee, R1 would not return to his/her normal baseline and R1 would become bed bound. Page 3 of 3. Based on the interviews conducted with clients and staff and based on observation and records review, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the above allegations did or did not occur, therefore the allegations are UNSUBSTANTIATED. No deficiencies cited from California Code of Regulations, Title 22. Exit interview conducted with LVN Residential Manager, Fidel Manuel and a copy of the report was provided.the state’s words, verbatim · CDSS document, Feb 20, 2024 · control 26-AS-20230810125235

Type of visit: Case Management - Other

Licensing Program Analyst (LPA) Simi Rai conducted an case management visit to address information obtained during the complaint investigation 8/10/2023. LPA Rai met with LVN Residential Manager, Fidel Manuel and stated the purpose of the visit. During investigation, it was disclosed that the resident (R1) did not have a physician's order to use bed rails. Resident Service Director (RSD) stated he/she was not aware of the regulation and did not have a physician's order on R1's file for using bed rails. RSD confirmed R1 was not receiving hospice services at the time of using the bed rails. During review of documents obtained during investigation, R1's has a history of falls, but Need and Services Plan did not state how facility will meet R1's fall-risk behavior. Based on review of R1's Appraisal dated 5/10/2023 stated R1 had a 9 episodes of fall in the past year. Based on review of R1's Physician's Report dated 6/17/2022, R1's physician has noted under "Other Conditions" as repeated falls. R1's Service Plan dated 5/10/2023 did mention the history of falls but it did not address R1's needs and how the facility would address this 'Physical/Health" concern. Deficiencies were cited per California Code of Regulations, Title 22, please see LIC 809-D. This report was reviewed with LVN Residential Manager, Fidel Manuel. A copy of the report and Appeal Rights were provided.the state’s words, verbatim · CDSS document, Feb 20, 2024

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87463(a) · Plan of correction due date: Feb 27, 2024

87463 Reappraisals (a) The pre-admission appraisal shall be updated, in writing as frequently as necessary to note significant changes and to keep the appraisal accurate. This requirement is not met as evidenced by: Based on interview and record review, R1's Service Plan did not address R1's history of falls which did not keep the appraisal accurrate which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 20, 2024

Plan of correction: LVN Residential Manager stated facility will submit a written plan of action on updating resident's appraisals accurately and understanding the regulations by POC due date.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87608(a)(3) · Plan of correction due date: Feb 27, 2024

87608 Postural Supports (a)(3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. This requirement is not met as evidenced by: Based on interview and record review, R1 did not have a written order from a physician for the bed rail which was in use which poses/posed a potential health, safety or personal rights risk to persons in care.the state’s words, verbatim · CDSS document, Feb 20, 2024

Plan of correction: LVN Residential Manager stated facility will submit a written plan of action on ensuring written order from a physician is maintained in resident's file who require a bed rail and understanding the regulations by POC due date.