Sunrise Care Home II

Allegation investigated: Facility staff financially exploited a resident

On 7/18/2022 at 10:50AM, Licensing Program Analyst (LPA) L. Ibo arrived unannounced to investigate the above allegation. LPA met with Administrator Nancy Tayag and informed her the purpose of the visit. During the course of investigation, based on LPA’s interview and records review, R1 is alert and oriented, R1 admitted that she owes money to S1. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is unsubstantiated. Exit Interview conducted and a copy of this report provided. Unsubstantiatedthe state’s words, verbatim · CDSS document, Jul 18, 2022 · control 15-AS-20220713130728

Type of visit: Case Management - Deficiencies

On 5/25/2022 at 11:20 AM, Licensing Program Analysts (LPAs) L. Francisco and K. Nguyen arrived unannounced to conduct a Case Management visit. LPAs met with Administrator, Nancy Tayag and explained the purpose of the visit. During the course of investigation for complaint (#15-AS-20210909122733), the following deficiency was observed. Interview with staff indicated staff were aware of R1's four wounds; one sore on each heel, one on buttocks and one on right heel. Staff confirmed the wound was not healing and did not seek medical attention for R1's buttocks and leg. In addition, facility did not notify responsible party nor submitted an incident report to CCLD.. The deficiencies were observed (see LIC 809D) and cited from the California Code of Regulations, Title 22. Failure to correct deficiencies may result in civil penalties. Exit interview conducted with Administrator. A copy of this report and appeal rights provided.the state’s words, verbatim · CDSS document, May 25, 2022

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87466 · Plan of correction due date: May 26, 2022

OBSERVATION OF THE RESIDENT The licensee shall ensure that residents are regularly observed for changes in physical....and that appropriate assistance is provided.....such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. This requirement is not met as evidenced by: Based on The Department's interviews, Licensee did not comply with the section cited above. Staff failed to seek medical attention once staff observed R1's wounds were not properly healing which poses an immediate health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 25, 2022

Plan of correction: Administrator agrees to review regulation and obtain training with a vendor covering topic. By POC date, Administrator will submit a registration confirmation and self-certification letter on understanding of regulation to CCLD.

From the deficiency page — Deficiency type: Type B · Section cited: CCR87211(a)(1) · Plan of correction due date: May 30, 2022

REPORTING REQUIREMENTS (a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...... This requirement is not met as evidenced by: Based on the Department's interview and record review, Licensee did not comply with the section cited above. Staff did not notify R1's responsible party and did not submit incident report to CCLD which poses a potential health and safety risk to residents in care.the state’s words, verbatim · CDSS document, May 25, 2022

Plan of correction: Administrator agrees to review regulation and obtain training with a vendor covering topic. By POC date, Administrator will submit a registration confirmation and self-certification letter on understanding of regulation to CCLD.

Type of visit: Case Management - Other

On 5/25/2022 at 11:20 AM, Licensing Program Analysts (LPAs) L. Francisco and K. Nguyen arrived unannounced for a Case Management visit to deliver amended report from complaint visit (cn# 15-AS-20210909122733) on 11/03/2021. LPAs met with Administrator Nancy Tayag and explained the purpose of the visit. Exit interview with Administrator and a copy of this report provided.the state’s words, verbatim · CDSS document, May 25, 2022

Allegation investigated: Illegal Eviction

***This is an amended report from the report issued on 5/06/21*** On 6/07/22 at 1:05 p.m. Licensing Program Analyst (LPA) G. Clark arrived unannounced to deliver this amended report. LPA met with Nancy Tayag, Administrator. During the course of investigation, LPA interviewed, client #1 (C1), complainant, facility administrator and 2 staff. C1's records including admission agreement were reviewed. Based on interviews conducted C1 currently has no financial means to pay for her placement at the facility. C1's family told facility administrator to take C1 to the ER and leave her there so the county would have to find placement. Facility Administrator reported to LPA that she had no intention of taking C1 to the ER and will issue a proper 30 notice to C1 for non-payment of monthly board and care. LPA advised Administrator of the proper components of an eviction notice. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Unsubstantiatedthe state’s words, verbatim · CDSS document, May 6, 2022 · control 15-AS-20220506135724

The state marks this report as 3 pages; the online copy we transcribed has 1. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 5/6/22 at 2:45 p.m., Licensing Program Analyst (LPA) G. Clark arrived unannounced to conduct Infection Control Inspection. LPA met with Administrator, Nancy Tayag and explained the purpose of the visit. During the Infection Control Inspection, LPA toured facility including but not limited to: front entrance, screening station, hand washing stations, bedrooms, common areas, kitchen and backyard. Facility has a sufficient 2-day perishable and one week non-perishable food supply. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, residents and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPE maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for residents and staff. No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, May 6, 2022

Allegation investigated: Personal RIghts - Resident sustained multiple pressure injuries while in care

On 11/3/2021 at 3:50 PM, Licensing Program Analyst (LPA) L. Francisco arrived unannounced to the deliver finding for the above allegation. LPA met with Administrator, Nancy Tayag and explained the purpose of the visit. During course of the investigation, the Department conducted interviews with facility residents, staff, witnesses, and complainant. Documents including but not limited to: resident’s (R1) admission agreement, physician’s report, care plan, staff notes, photos of resident, and discharged notes. REPORT CONTINUES ON 9099C Substantiated The Department investigated resident sustained multiple pressure injuries while in care. Based on record review of discharged notes, R1 was admitted to the hospital for “loss of appetite” on September 4, 2021. However, upon admission, it was noted R1 sustained multiple wounds in the following areas: heels, buttocks, lower legs, and hips. On 9/30/2021, R1 was admitted to skilled nursing facility on hospice for wound care. Staff notes indicated R1 was seen by a doctor on August 11, 2021 for the wounds on R1’s heels. R1 was referred to a podiatrist and an appointment was scheduled for September 1, 2021. However, it was cancelled due to R1 “not feeling well”. Based on interview and record review, R1 was not seen by a doctor for R1’s other wounds. Therefore, there was no doctor’s order for wound care instructions. Based on the information obtained, interviews and record reviews that the Department obtained during investigation, the preponderance of evidence standard has been met; therefore, the above allegations are SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099D. A $500 civil penalty is assessed for violation that resulted in a serious injury. Additional civil penalties and/or Administrative Action may occur. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Nov 3, 2021 · control 15-AS-20210909122733

From the deficiency page — Deficiency type: Type A · Section cited: HSC 1569.269(a)(10) · Plan of correction due date: May 25, 2022

***THIS IS AN AMENDED REPORT FROM VISIT ON 11/3/2021*** ENUMERATED RIGHTS; SEVERABILITY (a) Residents of residential care facilities for the elderly shall have all of the following rights: (10)To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse. This requirement is not met as evidenced by: Based on interview and record review, Licensee did not comply with the regulation cited above. R1 sustained multiple wounds while in care which poses an immediate health and safety risk to persons in care.the state’s words, verbatim · CDSS document, Nov 3, 2021

Plan of correction: Administrator will review regulation and submit self-certification letter to CCL by POC date. A formal meeting will be scheduled at a later time. $500 Civil Penalty is being assessed.