Sunnyside Gardens

Type of visit: Case Management - Incident

On 06/12/2026 Licensing Program Analyst (LPA) Yi Sam Jian arrived unannounced to conduct a case management visit regarding a recently incident report at the facility. LPA met with Administrator (ADM) Brisa Romero. LPA stated the purpose of the visit. The purpose of the visit was to follow-up on an incident report received for resident (R1) reported to Community Care Licensing Division (CCLD) on 6/11/2026. During visit, LPA interviewed ADM, and collected documentation. No deficiencies cited during today's visit per California Code of Regulations, Title 22, the department may conduct further investigation. An exit interview was conducted with ADM and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Case Management - Incident

On 06/12/2026 Licensing Program Analyst (LPA) Yi Sam Jian arrived unannounced to conduct a case management visit regarding a recently reported death at the facility. LPA met with Administrator (ADM) Brisa Romero. LPA stated the purpose of the visit. The purpose of the visit was to follow-up on a death report received for resident (R1) reported to Community Care Licensing Division (CCLD) on 6/11/2026. During visit, LPA interviewed ADM, and collected documentation. ADM stated to LPA the facility will provide updates to the Department on R1's death certificate once it becomes available. The department may conduct further investigation. An exit interview was conducted with ADM and a copy of this report was provided.the state’s words, verbatim · CDSS document, Jun 12, 2026

Type of visit: Required - 1 Year

On March 27, 2026, Licensing Program Analyst (LPA) Murial Han conducted an annual inspection. Upon entry, LPA was greeted by the receptionist, Atefe Halilozer and LPA explained the purpose of today's visit. The assist. administrator, Brisa Romero arrived shortly thereafter and assisted with the annual inspection. The asst. administrator provided a tour of the facility and LPA observed, the Assisted Living and Memory Care Units, resident rooms, bathrooms, shower rooms, dining rooms, activities rooms, medication rooms and outdoor area. LPA observed the facility is equipped with the required furniture, comfortable temperature is maintain and lighting is sufficient for comfort. LPA observed all exit doors in the rooms had auditory alarms for notification. Emergency pull cords were next to the resident beds and in the resident bathrooms. “Oxygen in use” signs were posted outside the resident’s room using oxygen. The hot water temperature in the resident's bathrooms was measured between the range of 111 F to 117 F. During the tour, LPA observed staff members were conducting varies activities and engaging residents. LPA observed medication, chemicals, toxins, and sharps objects were locked and inaccessible to residents. Disaster records were observed to be sufficient. A review of (6) resident files was conducted and noted on LIC 858. A review of (6) staff files was conducted and noted on LIC 859. No deficiency is cited today. This report is reviewed and discussed with the asst. administrator. A copy is provided.the state’s words, verbatim · CDSS document, Mar 27, 2026

Type of visit: Required - 1 Year

On March 19, 2025, at 9:00 AM, Licensing Program Analyst (LPA) Kiran Jain arrived unannounced at the facility to conduct a Required 1-Year Annual inspection. LPA met with the Executive Director (ED), Karen Mandair and disclosed the purpose of the inspection. The ED informed the LPA that the facility currently has 42 residents in care, 28 residents in Assisted Living and 14 residents in Memory Care. At 9:38 AM, the LPA initiated a walk-through of the facility, accompanied by a staff member. LPA inspected six (6) random resident rooms in the Assisted Living and five (5) random resident rooms in the Memory Care, and found them clean, well-lit, and equipped with the required furniture. All exit doors in the rooms had auditory alarms for notification. Emergency pull cords were observed working next to the resident beds. “Oxygen in use” signs were posted outside the resident’s room using oxygen. LPA inspected private bathroom in all the rooms. The bathrooms contained soap, grab bars, towels, a trash can, and non-slip flooring. The hot water temperature at the sink faucet was measured between the range of 112.8°F to 119.5°F. LPA inspected the common resident bathroom with shower and found it clean, sanitary, and in good working condition. It contained soap, grab bars, a trash can, non-slip flooring, curtain, shower bench, and a shower chair. LPA inspected the laundry room and observed two (2) sets of industrial size washer and dryer, and on (1) set of a residential washer and dryer in working condition. LPA inspected the kitchen and found it clean. LPA inspected the refrigerator, freezer, and pantry room and observed enough supplies of fresh perishable food for (2) days and nonperishable staples for (7) days. LPA inspected the dining room and lounge area and found it clean, with all the furniture in good repair. LPA observed residents participating in the painting activity in the lounge area. Continued on LIC 809-C LPA inspected the fire extinguishers mounted on the hallway walls in Assisted Living and Memory care, and found they were fully charged with a last service tag of 09/04/2024. The staff member tested the smoke and carbon monoxide detector located in the hallway in the LPA's presence, and it was found to be functional. LPA toured the patio and yard area and found ramps and passageways in good condition, clear of obstructions, with no blocking or tripping hazards. These areas had patio tables, chairs, and umbrellas for residents’ use. Delayed egress was observed on all exit doors. LPA reviewed (5) staff personnel records and (5) resident records. The LPA observed that 5 of 5 residents had the Admission Agreement, Physician's Report, Appraisal Needs and Services Plan, and CSDMR. LPA observed that 5 of 5 staff members had LIC 508 Criminal Record Statements and LIC 503 Health Screening and confirmed that 5 of 5 staff members were associated with the facility. LPA observed a locked centrally stored medication cart located inside the medication room, in both Assisted Living and Memory care units. Medications were organized in separate bins for each resident. All medication bottles and bubble packs were properly labeled. Centrally Stored Medication Records (CSMR) were reviewed and found to be complete. LPA inspected the first aid kit and found it fully stocked. Emergency Drill Logs were reviewed, and it was observed that Emergency Disaster Drills were conducted monthly, with the most recent drill completed on 01/31/2025. The following updated forms are requested to be submitted to CCLD by 03/26/2025: LIC 500: Personnel Report LIC 308: Designation of Facility Responsibility LIC 400: Resident Cash Resources Affidavit LIC 402: Surety Bond LIC 999: Updated Facility Sketch (Floor Plan) Certificate of Liability Insurance Administrator Certificate(s) Continued on LIC 809-C No deficiencies were cited during today's visit. An exit interview was conducted with the Assistant Executive Director. A copy of this report was left with the Assistant Executive Director, Brisa Romero, whose signature on this form confirms receipt of the report.the state’s words, verbatim · CDSS document, Mar 19, 2025

Allegation investigated: Staff not trained in Medication Administration Unqualified staff giving insulin injections and blood sugar tests

Unannounced complaint visit made out to this facility on 12/14/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the weekend manager on duty, Brisa Romero, who also held the role as the Assistant Executive Director at this time. A brief interview was conducted with the facility representative Brisa Romero at this time. Current census was 41 residents. The purpose of this visit was to inform this facility, and its representative Brisa Romero, that an ongoing investigation had been completed and the following findings were being delivered at this time. Based on interviews conducted during the course of this investigation, it was learned that facility staff designated as Medication Technicians (Med Techs) were trained with the duties and responsibilities to handle, dispense, and document the resident medications at all times. It was learned that these individuals received additional hours of training on an initial and ongoing basis. It was learned that these Med Techs were allowed to assist residents with Blood Glucose Testing and Insulin Pen Dialing for Self Injection. Substantiated These training procedures were outlined in the packet that was designated for facility staff training and medication assistance procedures submitted by the facility designated Administrator into CCL for review. These procedures and staff related tasks outlined and stated the following: Insulin Pen Dialing for Self Injection on page 72 Hand resident the insulin pen, and ensure they have a secure grip secure before letting go to avoid dropping. Be aware of exposed needle at all times Allow resident to self administer injection and have them hold pen in place for 10 seconds Blood Glucose Checks on page 74 Hand resident the blood glucose meter, and ensure they have a secure grip secure before letting go to avoid dropping. Be aware of exposed needle/lancet at all times Watch resident pierce their finger and place blood onto test strip according to manufacturer instructions It was learned that facility staff designated as Med Techs had to be passed and checked off by an evaluator prior to being able to handle, dispense, and document the resident medications on their own. This was done so by the Competency Verifications for the same policies and procedures conducted on Pages 78, 80, and 81 of the Medication Assistance Procedures. It was learned that facility staff designated as Med Techs were allowed to assist residents with Blood Glucose Check by using hand over hand techniques to assist with piercing their finger and placing the blood onto the test strips. It was learned that facility staff designated as Med Techs were allowed to assist residents with Insulin Pen Dialing for Self Injection by using hand over hand techniques to assist with injections and holding the pen in place for 10 seconds. Based on a review of the forms and documents, as well as interviews conducted, facility staff designated as Med Techs were allowed to conduct these types of assistance with hand over hand with facility residents Manager, Brisa Romero, who also held a current Administrator Certificate at this time. Based on a tour of the facility that was conducted, it was learned that all resident medications were centrally stored in the Memory Care Unit at all times. It was observed that resident medications that were to be dispensed on a daily basis were stored in a mobile cart. It was observed that this mobile cart was locked and made inaccessible to the residents at this time. It was learned that overflow medications were stored in bins in a closet type until also found in the facility medication room. It was learned that this medication room was locked at all times except in the case when facility staff, designated as Med Techs, were present to pour the medications and ready them for dispensing to the residents. A review of the facility medication administration record (MAR) and dispensing log was conducted. It was observed that the medications were being dispensed and documented as prescribed by the responsible licensed medical professionals at this time. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegations finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violations occurred. There were no deficiencies observed or cited at this time. Exit Interview requiring assistance with Blood Glucose Checks and Insulin Pen Dialing for Self-Injection without proper documented training. It was learned that these techniques were not found to be present in the Medication Assistance Procedures at this time even though they were being conducted and performed by the Med Techs at this time. As a result of this investigation, this LPA found the allegations to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegations were valid because the preponderance of the evidence standard had been met. The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes. Appeal rights were printed and a copy was left with the facility designated representative at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Dec 14, 2024 · control 26-AS-20220427093207

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87465(a)(5) · Plan of correction due date: Dec 21, 2024

Facility staff, except those authorized by law, shall not administer injections, but staff designated by the licensee may assist persons with self-administration as needed. This facility was found to be deficient as evidenced by facility staff designated as Med Techs were practicing hand over hand when assisting residents with Blood Glucose Checks and Insulin Pen Dialing for Self-Injection without proper documented training for these techniques posing an immediate threat to the Health, Safety, and Personal Rights of the residents in care.the state’s words, verbatim · CDSS document, Dec 14, 2024

Plan of correction: The facility designated representative stated that all staff designated as Med Techs will be scheduled and trained, for no less than (2) hours in duration, on the topics of hand over hand techniques when assisting residents with Blood Glucose Checks and Insulin Pen Dialing for Self-Injection. A statement of correction, along with documented proof of training, will be completed and submitted into CCL by the due date. Proof of training will include the name of the trainer, topics that were trained, and a list of the attendees.

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87208(a)(6) · Plan of correction due date: Dec 21, 2024

Each facility shall have and maintain a current, written definitive plan of operation. The plan and related materials shall be on file in the facility and shall be submitted to the licensing agency with the license application. Any significant changes in the plan of operation which would affect the services to residents shall be submitted to the licensing agency for approval. The plan and related materials shall contain the following: Plan for training staff, as required by Section 87411(c). This facility was found to be deficient as evidenced by facility staff designated as Med Techs were practicing hand over hand when assisting residents with Blood Glucose Checks and Insulin Pen Dialing for Self-Injection without proper documented updated training for these techniques posing an immediate threat to the Health, Safety, and Personal Rights of the residents in care.the state’s words, verbatim · CDSS document, Dec 14, 2024

Plan of correction: The facility designated representative stated that the Program Description for this facility, specifically for Medication Assistance Procedures, will be updated to reflect the proper training for hand over hand techniques utilized by facility staff designated as Med Techs. A statement of correction, along with a copy of the updated Program Description, specifically for Medication Assistance Procedures, will be completed and submitted into CCL by the due date.

Allegation investigated: Facility is not addressing insect infestation Staff do not give prescribed medication to resident

Unannounced complaint visit made out to this facility on 12/14/2024 by Licensing Program Analyst (LPA) Charlie Yang who was met by the weekend manager on duty, Brisa Romero, who also held the role as the Assistant Executive Director at this time. A brief interview was conducted with the facility representative Brisa Romero at this time. Current census was 41 residents. The purpose of this visit was to inform this facility, and its representative Brisa Romero, that an ongoing investigation has been completed and the following findings were being delivered at this time. Based on a review of the facility medication administration record (MAR) and dispensing log that was conducted, it was observed that the medications were being dispensed and documented as prescribed by the responsible licensed medical professionals at this time. Based on a review of the facility's contracted third party vendor for pest control, Ecolab Pest Elimination Divison, it was observed that this company made one to two visits a month out to this facility. It was observed that the contract outlined services for cockroaches, rodents, flies and ants. Unsubstantiated Based on a review of the pest control reports dating back to 02/02/2022, it was observed that the findings for these inspections performed by Ecolab did not show that there were issues of pests for this facility at that time. It was observed that there were suggestions for structural concerns to fill gaps and holes within the kitchen area but no pest activity was found during the dates of service. As a result of this investigation, this Department found the allegations to be UNSUBSTANTIATED. A complaint allegations finding of Unsubstantiated meant that although the allegations may have happened or were valid, there was not a preponderance of the evidence to prove that the alleged violations occurred. There were no deficiencies observed or cited at this time. Exit Interview presence of any ants and other pests if they were to be present at that time. As a result of this investigation, this LPA found the allegation to be SUBSTANTIATED - A finding that the complaint was Substantiated meant that the allegation was valid because the preponderance of the evidence standard had been met. The following deficiencies were observed and cited on the following LIC 9099-D pursuant to Title 22 Rules and Regulations, Division 6 and Health and Safety Codes. Appeal rights were printed and a copy was left with the facility designated representative at this time. Exit Interviewthe state’s words, verbatim · CDSS document, Dec 14, 2024 · control 26-AS-20220823145843

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87303(a) · Plan of correction due date: Dec 15, 2024

The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This facility was found to be deficient as evidenced by the presence of ants in a resident room which prompted a move to another room for the resident which posed an immediate threat to the Health, Safety, and Personal Rights of the residents in care.the state’s words, verbatim · CDSS document, Dec 14, 2024

Plan of correction: The facility designated representative stated that the contracted pest control company, Ecolab, will be notified to concentrate and focus on the prevention of ants at this time. A statement of correction, along with proof of contracted pest control services rendered for ant control, will be completed and submitted into CCL by the due date. This facility has provided forms and documents for contracted services through Ecolab for the prevention of cockroaches, flies, rodents and ants at this time. No further plan of correction required at this time.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Maria (Mita) Partoza conducted an unannounced required annual inspection and met with facility's Business Office Director/Assistant Exec Director (BOD/AED) Brisa Romero The facility's census is 34 resident and 54 staff. LPA toured the facility, including entryway, common room, dining room, kitchen, laundry room, 4 bedrooms, 3 bathrooms, medicine room, and activity room. LPA toured the exterior of the facility and observed all walkways and emergency exits are free from obstruction. No prohibited items were observed in the resident rooms. All emergency exits are clear from obstruction. The facility has housekeeping schedule for the residents. LPA toured the memory care section and tested the door alarms and found it to be in good working condition. Facility has activities scheduled posted for the whole month. LPA observed residents participating during activity time. LPA tested the facility water temperature. Water temperature measured between 119 to 120 degree Fahrenheit. LPA observed sufficient supply of food, 2 days of perishable food and 7 days for non-perishable food. Fire extinguisher was last inspected on 9/21/2023. All toxins are kept in a locked room. Knives are locked and is not accessible to residents. LPA reviewed the facility's fire alarm log. The fire alarms system for the entire building was inspected and tested on 01/09/2024 and were found to be in good working condition (test result passed). continued to LIC 809C page 1 of 2 LPA reviewed 3 resident files and 3 staff files. LPA reviewed the Centrally Stored Medication and Destruction Report for 3 residents and found all records to be updated. Disaster training for the facility was updated. LPA reviewed the staff personnel record and training information and found record to be updated and complete. No deficiency was cited during today's visit per CCR Title 22. This report was reviewed with Business Office Director/Assistant Exec Director (BOD/AED) Brisa Romero and a copy of the signed report was provided electronically by email due to printer error.the state’s words, verbatim · CDSS document, Mar 15, 2024

Allegation investigated: Resident has sustained multiple falls while in care due to neglect.

Licensing Program Analyst (LPA) Steve Chang conducted an unlicensed complaint investigation visit to deliver the investigation findings and met with Business Office Director Brisa Romero (BOD). On 05/04/2021, the Department received a complaint with an allegation that Resident has sustained multiple falls while in care due to neglect. On 5/14/2021, an initial investigation visit was conducted. LPA toured the facility, and interviewed 5 staff (S1 -S5) and 4 residents (R1 - R4). Residents' physician reports and residents Care Plans were obtained. On 5/17/2023, Administrator Karen Mandair was interviewed. Continue on LIC9099-C. Page 1 of 3. Unsubstantiated Resident has sustained multiple falls while in care due to neglect: On 05/14/2021, LPA interviewed resident R1. R1 stated he/she was fine to stay in the facility. R1 stated he/she was able to get help from staff to get around in the facility whenever he/she asked for help. On the same day, LPA interviewed 3 residents (R2 - R4). 3 Out of 3 stated they got help from staff when they moved from bed, went to restroom or get around in the facility. R3 stated the facility staff reminded residents to ask for help to get around in the facility. On 5/14/2021, LPA interviewed staff S1. S1 stated 6 residents were assigned as a group and each group was supervised by 1 caregiver; caregivers still help residents in different groups if needed. S1 stated the facility always reminded residents to ask for help whenever they wanted to move. S1 stated R1's hospice care nurse suggested to provide a device for R1 to prevent falls which the facility did not have. The facility communicated with the family member of R1, but R1's family member disagreed to purchase. S1 stated R1 needed help to move around, but sometimes R1 tried to move around by self. S1 denied staff neglected residents. On the same day, LPA interviewed 4 staff, all of them stated they reminded residents to ask for help when residents wanted to move. All of them stated they always helped residents when residents wanted to move. All of them stated they never neglected residents needed help. 2 staff stated the number of caregivers were enough to provide care and supervision to residents. 2 staff stated R1 sometimes wanted to walk without staff help that caused R1 sustained falls. On 5/14/2021, LPA toured the facility. LPA observed staff in memory care unit were readily to help residents. LPA observed staff helped residents to stand up from chairs, and assisted residents to walk around with walkers. LPA observed staff helped residents participated in the activities. Continue on LIC9099-C. Page 2 of 3. On 5/17/2021, LPA interviewed Administrator (ADM). ADM stated R1 had a fall on 5/16/2021, and the facility started to conduct hourly check for R1. ADM stated the facility suggested R1's family member to purchase extra device for R1 to prevent R1's falls and to purchase extra service such as hiring extra private caregiver for R1, but R1's family refused. ADM stated he/she will discuss with R1's family member for updating R1's care plan. ADM stated if R1's family member disagrees with the new proposed care plan, the facility will suggest that R1 to move to a small facility such as 6 beds facility. ADM denied the facility staff neglected residents. Reviewing R1's medical documents, R1 was non ambulatory, and had history falls; according two staff's statement that R1 sometimes would like to walk by self without staff's help; R1 recently had more falls, R1's care plan should be updated such as hiring an extra private caregiver. Based on the observation and interviews conducted, 6 Out of 6 staff denied neglected residents. Residents were instructed to ask for help when they wanted to move. Facility to update care plan due to R1's frequent falls. Facility increased the frequency of checking for R1 due to R1's falls. The facility figured out the solution plan to help R1. Caregivers were observed to assist residents to stand up from chair, to move around, and to walk around with walkers. Staff were observed residents to participate in the activities. The facility staff did not neglect residents. The Department has investigated the above allegation. Based on observation, and interviews conducted, the Department found that the above allegation is 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 citations cited under California Code of Regulations Title 22. Exit interview conducted with BCD. The report was provided to BCD for signature. A copy of the report was provided to BCD. Page 3 of 3.the state’s words, verbatim · CDSS document, Sep 28, 2023 · control 26-AS-20210504122012