Sunset Residential Care I

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ramin Hashemi conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Licensee Yanet Puentes Lopez . The facility's license shows a maximum capacity of six (6) non-ambulatory residents, ages 60 and over. The facility has an approved hospice waiver for six (6). During today’s inspection there were four (4) residents in care. LPA and Licensee toured the interior and exterior of the facility and inspected each room. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to clients. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per licensee, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher(s) were serviced within the last 12 months. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed staff and clients, and reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. Two (2) deficiencies were cited per California Code of Regulations, Title 22 (refer to the LIC 809-D pages). Plans of Correction were jointly developed with the Licensee. An exit interview was conducted with Licensee Yanet Puentes Lopez. A copy of this report, the LIC 809-D pages, and the Licensee/Appeal Rights (LIC9058 03/22) were provided to Licensee during today's visit.the state’s words, verbatim · CDSS document, Feb 25, 2026

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Arian Golbakhsh conducted an unannounced, required Annual Inspection. The facility file and personnel report was reviewed prior to the visit. LPA was welcomed by, identified themselves to, and discussed the purpose of the visit to caregiver and Romelia Solis and private caregiver Maria Del Rio. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. The facility is also approved for six (6) hospice residents. During today’s inspection there were three (3) residents in care. LPA and Caregiver Damian Ordaz Arencibia toured the interior and exterior of the facility and inspected each room. Administrator Yanet Puente Lopez joined later in the visit. The facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Hot water temperature at taps accessible to clients were all compliant: Bathroom sink was 105F. Extra linens and hygiene supplies were present, as well as Personal Protective Equipment. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. The facility contained at least two (2) days of perishable food, and at least seven (7) days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. Knives were locked and secured. [Continued on LIC 809-C] [Continued from LIC 809] During the tour, LPA noticed the doorway from the kitchen to the garage was not secured, presenting a risk for residents in accessing toxic chemicals and poisons kept in the garage. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per caregiver Damian, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguisher was serviced within the last 12 months. First aid kit was complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA interviewed (2) staff and (0) clients, and interviews did not reveal any licensing or regulatory concerns. LPA reviewed facility records. The files reviewed by LPA contained required documents, and it was revealed a private caregiver was present and working at the facility without a criminal background clearance. Confidential records were stored in locked areas. Two (2) deficiencies were cited during the inspection. An exit interview was conducted with Administrator Yanet Puente Lopez to whom a copy of this report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided. Their signature below confirms receipt of these documents.the state’s words, verbatim · CDSS document, Feb 18, 2025

Type of visit: Case Management - Annual Continuation

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Annual Continuation Inspection. The LPA introduced himself and disclosed the purpose of the visit to Administrator Yanet Puentes. The facility was licensed for capacity of six (6) non-ambulatory residents, and approved for a hospice waiver for six (6) residents. During the annual visits the facility was clean, sanitary, and in good repair. Pathways were free of obstruction and slip hazards. Client bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and client activities. There was at least 2 days of perishable food, and at least 7 days non-perishable food present, all safely stored. Cooking/dining equipment and utensils were present. There were no toxic chemicals/poisons accessible to clients. Medications were labeled, and stored in locked areas. No pools, nor bodies of water were observed on the premises. Per staff, no firearms, nor ammunition were kept at the facility. A carbon monoxide detector, facility telephone, and fire extinguisher were present. Required licensing postings were observed in visible areas of the facility. The LPA interviewed staff and reviewed multiple staff and client records/files. Technical advised was provided and deficiencies noting missing documents were cited in an LIC 809D. A plan of correction was jointly formulated with the administrator. An exit interview was conducted with Administrator Puentes, to whom a copy of this report, LIC 809D, and the Licensee/Appeal Rights (LIC9058), were provided.the state’s words, verbatim · CDSS document, Mar 13, 2024

Type of visit: POC

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Plan Of Correction (POC) visit. The LPA introduced himself, and disclosed the purpose of the visit to Administrator Yanet Puentes. During the visit, the LPA reviewed records, cleared a POC, and provided the administrator a Plan of Correction Letter. An exit interview was conducted with Administrator Puentes, to whom a copy of this report, and Applicant/Licensee Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Mar 13, 2024

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. The LPA introduced himself and disclosed the purpose of the visit to Caregiver Lizbeth Razo. Administrator Yanet Puentes arrived during the visit and assisted the LPA. During today’s visit, The LPA toured the facility, and reviewed staff and resident records. No deficiencies were cited during today’s visit. Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection. An exit interview was conducted with Administrator Puentes, to whom a copy of this report, and the Licensee/Appeal Rights (LIC9058), were providedthe state’s words, verbatim · CDSS document, Feb 29, 2024

Allegation investigated: Uncleared staff Staff do not have required training

Licensing Program Analyst (LPA), Sabel Martinez, conducted an unannounced follow up complaint investigation visit, and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Caregivers Lizbeth Razo and Diana Parra. Administrator Yanet Puentes arrived during the visit and assisted the LPA. Throughout the investigation, the Department secured pertinent records and conducted interviews with internal and external sources. It was alleged the facility employed uncleared staff. I was reported to the Department the facility had staff that did not have a criminal background clearance. Interviews with internal and external sources revealed there were two staff, Staff #1 (S1) and Staff #2 (S2), who had worked at the facility for several months. Interviews revealed that S1 and S2 had provided supervision and assistance to residents with activities of daily living, including assistance with medication, assistance with getting out of bed, and assistance with bathing. Substantiated A review of the facility’s personnel roster along with the Guardian System confirmed S1 and S2 were not associated to the facility. Additionally, an interview with the administrator revealed S1 and S2 had been to the facility on multiple occasions and had shadowed staff to increase their knowledge of what the job entailed. It was alleged staff did not have the required training. Review of records along with an interview of the administrator, revealed staff trainings were not documented and kept at the facility, as required per California Code of regulations Title 22. Additionally, the administrator confirmed S1 and S2 were not trained, but instead S1 and S2 only shadowed staff to familiarize themselves with the work. This was done to determine if S1 and S2 wanted to apply for employment in the future. Training records for Staff #3 (S3), Staff #4 (S4), and Staff #5(S5) were also not produced for the LPA to review. Based on the evidenced obtained throughout the investigation, the alleged violations were Substantiated and cited in an LIC 9099D. A civil penalty was also assessed during the visit. A plan of correction was jointly formulated with Administrator Puentes. An exit interview was conducted with Puentes, to whom a copy of this report, LIC 811 Confidential names list, LIC 421 BG, and Licensee/Appeals Rights (LIC 9058) were provided. An exit interview was conducted with Administrator Puentes, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.the state’s words, verbatim · CDSS document, Feb 15, 2024 · control 08-AS-20240109135721

From the deficiency page — Deficiency type: Type A · Section cited: CCR 87355(e)(1) · Plan of correction due date: Feb 15, 2024

87355 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or: This requirement was not met as evidenced by: Based on review of records and interviews, the Licensee did not ensure two staff, S1 and S2, obtained a California Clearance prior to working, which posed an immediate Health, Safety, and Personal Rights risk to 5 of 5 person in care.the state’s words, verbatim · CDSS document, Feb 15, 2024

Plan of correction: Administrator agreed to not have S1, and S2 work at the facility, nor volunteer, until S1 and S2 obtained a criminal background clearance. POC was cleared on today's date, as the LPA witnessed S1 and S2 were not at the facility.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87411(c) · Plan of correction due date: Feb 15, 2024

87411 Personnel Requirements - General (c) All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69- This requirement was not met as evidenced by: Based on review of records and interviews, the Licensee did not ensure staff (S3,S4, and S5) did not received initial and annual training, which posed a potential health, safety, and personal rights risk to 5 of 5 residents in care.the state’s words, verbatim · CDSS document, Feb 15, 2024

Plan of correction: Adminitrator agreed to provide the LPA documentation of staff trainings for S3, S4, and S5, by 3/15/24.