SUNRISE CARE HOME II

Official classification

Type A

Official code

87355(e)(3)

Regulation authority

CCR

What the official deficiency says

(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: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or This requirement is not met as evidenced by: Deficient Practice Statement Based on record review the Licensee did not comply with the section cited above in not having S1 associated to the facility which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/19/2026 Plan of Correction By POC date, the Administrator agrees to complete an LIC9182 form and attach a copy of S1's photo ID and send the documents to CCLD to associate S1.

Official classification

Type A

Official code

1569.618(c)(3)

Regulation authority

HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review and interview, the licensee did not comply with the section cited above in having 0 out of 3 staff members on duty without CPR training on duty had proof of CPR training which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2025 Plan of Correction The Administrator agrees to schedule at least one staff member to recieve CPR training and submit documentation of scheduled training to CCLD by POC date. Administrator agreed to also send the completion of the training on 08/21/2025.

Official classification

Type A

Official code

87411(c)(1)

Regulation authority

CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that 0 out of 3 staff members did not have first aid certification on file which poses an immediate health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/01/2025 Plan of Correction The Administrator agrees to schedule all staff members to recieve first aid training and submit documentation of scheduled training to CCLD by POC date. Administrator agreed to also send the completion of the training on 08/21/2025.

Official classification

Type B

Official code

1569.625(b)(2)

Regulation authority

HSC

What the official deficiency says

(2) In addition to paragraph (1), training requirements shall also include an additional 20 hours annually, eight hours of which shall be dementia care training, as required by subdivision (a) of Section 1569.626, and four hours of which shall be specific to postural supports, restricted health conditions, and hospice care, as required by subdivision (a) of Section 1569.696. This training shall be administered on the job, or in a classroom setting, or both, and may include online training. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above in that S2 and S3, had missing 20 hr annual training which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2025 Plan of Correction Administrator agreed to submit documentation of completed 20 hr annual training to CCLD by POC date.

Official classification

Type B

Official code

87458(c)(1)

Regulation authority

CCR

What the official deficiency says

(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, the licensee did not comply with the section cited above by not having an updated medical assessment for R1,R2, R3, and R4 which poses a potential health and safety to persons in care.

Official plan of correction

POC Due Date: 08/21/2025 Plan of Correction Administrator agreed to provide a copy of R1,R2, R3, and R4's medical assessment (LIC-602) to CCLD by the POC date.

Official classification

Type B

Official code

87608(5)(a)

Regulation authority

CCR

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement Based on observation and record review, the licensee did not comply with the section cited above in not having an doctor orders for half bed rails for R1, R2, R3, R4, and R5 which poses a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2025 Plan of Correction Administrator agreed to email CCLD doctor orders or invoice for hospital beds with half rails by POC date.

Official classification

Type B

Official code

1569.695(c)

Regulation authority

HSC

What the official deficiency says

This requirement is not met as evidenced by: Deficient Practice Statement Based on interview and record review, the licensee did not comply with the section cited above by not conducting emergency disaster drills quarterly which poses a potential health and safety risk to persons in care.

Official plan of correction

POC Due Date: 08/21/2025 Plan of Correction Administrator agreed to conduct a disaster drill, document and email a copy of document to CCLD by POC date.

Official classification

Type A

Official code

87466

Regulation authority

CCR

What the official deficiency says

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.

Official 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.

Deadline recorded: May 26, 2022. A deadline is not proof that correction was completed.

Official classification

Type B

Official code

87211(a)(1)

Regulation authority

CCR

What the official deficiency says

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.

Official 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.

Deadline recorded: May 30, 2022. A deadline is not proof that correction was completed.

Official classification

Type A

Official code

1569.269(a)(10)

Regulation authority

HSC

What the official deficiency says

***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.

Official 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.

Deadline recorded: May 25, 2022. A deadline is not proof that correction was completed.