306005811-7-20-2023-22-AS-SSAS-CU8BG9-20230730010334

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005811
Report Date: 07/20/2023
Date Signed: 07/20/2023 10:07:51 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/05/2023 and conducted by Evaluator Joseph Alejandre

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20230705162332

FACILITY NAME:	MORNING SUNRISE VILLA		FACILITY NUMBER:	306005811
ADMINISTRATOR:	GRANVILLE, NIDA		FACILITY TYPE:	740
ADDRESS:	9061 ORANGEWOOD AVE.		TELEPHONE:	(714) 530-7522
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92841
CAPACITY:	6	CENSUS: 4	DATE:	07/20/2023
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Nida Granville		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Facility left resident at the hospital unattended
Facility failed to report to licensing

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Joseph Alejandre made an unannounced visit to deliver the findings of the complaint investigation into the allegations listed above. LPA met with Administrator Nida Granville and explained the reason for the visit. The investigation into the allegation, facility left resident at the hospital unattended revealed the following. Resident 1 (R1) moved out of the facility on July 1, 2023. Staff and R1’s responsible party verified this information. Facility staff reported they never took R1 to the hospital. R1’s responsible party verified this report. Sometime on or around July 3, 2023, R1 was hospitalized and remained at the hospital until July 5th. It is unclear when R1 was discharged from the hospital. Staff reported they had no knowledge of R1’s whereabouts after July 1 and have had no contact with R1’s responsible party. R1’s responsible party verified this report. R1’s responsible party reported that R1 was taken to the hospital after they were moved out of the facility. Witness (W1) interviewed who had knowledge of the incident reported that R1 was at the hospital July 3rd, 2023 to July 5th, 2023, which is after they moved out of the facility.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20230705162332

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: MORNING SUNRISE VILLA	FACILITY NUMBER: 306005811
	VISIT DATE: 07/20/2023

NARRATIVE

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Based on the evidence gathered the allegation, facility left resident at the hospital unattended, is deemed unfounded meaning the allegation is false could not have happened and/or is without a reasonable basis.

Regarding the allegation, facility failed to report to licensing, revealed the following. It was alleged that the facility should have reported to licensing when Resident 1 (R1) was taken to the hospital July 3rd. Facilities are required to report to licensing within 7 days any incident which threatens the welfare, safety or health of any resident… (California Code of Regulations, Title 22, Division 6, Chapter 8, 87211 (a)(1)(D)). R1 moved out of the facility on July 1, 2023. This report was verified by facility staff and R1’s responsible party. The facility staff reported that they had no knowledge of R1 being transported to a hospital. R1’s responsible party reported that they did not have any contact with facility staff since July 1, 2023. R1 was taken to the hospital on July 3, 2023. R1’s responsible party verified this information. R1 moved out of the facility on July 1, 2023, and was no longer a resident of the facility when R1 was taken to the hospital. The facility is not responsible for reporting incidents concerning former residents. Based on the evidence gathered the allegation, facility failed to report to licensing, is deemed unfounded meaning the allegation is false could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of the report provided.

SUPERVISORS NAME: Luz Adams
LICENSING EVALUATOR NAME: Joseph Alejandre
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

LIC9099 (FAS) - (06/04)

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