347004534-12-19-2024-59-AS-MSEY-DC62BQ-20241220161527

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347004534
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:16:55 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/08/2024 and conducted by Evaluator Sabrina Calzada

PUBLIC

COMPLAINT CONTROL NUMBER: 59-AS-20241108132346

FACILITY NAME:	SUNRISE RESIDENTIAL CARE SERVICES INC. #4		FACILITY NUMBER:	347004534
ADMINISTRATOR:	MAYE DICKEY		FACILITY TYPE:	740
ADDRESS:	7233 CAMEL ROCK WAY		TELEPHONE:	(916) 560-3525
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	4	CENSUS: 4	DATE:	12/19/2024
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Elisabeth Lucas, lead staff		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff did not prevent a resident from assaulting another resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to deliver complaint findings for a complaint received on 11/8/24. LPA met with Elisabeth Lucas, Teodoro Lucas, DSP, and stated the reason for today's inspection. Care staff, Lita Cailing, was also present but was not scheduled to work today. LPA observed (2) clients present in the common area and was advised (2) clients were out of the facility, attending day program or visiting family. LPA spoke to Administrator, Maye Dickey, by phone, who indicated she was not able to attend today's inspection and authorized staff, Elisabeth, to sign the reports.

During the investigation, LPA Interviewed the Administrator, (1) lead care staff, clients (C1 and C2) , (2) Regional Center staff and (2) day program managers. LPA reviewed (C1's) Progress report dated 8/1/24.
The results of the investigation are as follows:

(C1) moved to care home in June 2024 from a related care home. Client (C1) has a diagnosis of Mild Intellectual Disability, Hypothyroidism and is not conserved.
*cont on 9099C-1..

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024

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 59-AS-20241108132346

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUNRISE RESIDENTIAL CARE SERVICES INC. #4	FACILITY NUMBER: 347004534
	VISIT DATE: 12/19/2024

NARRATIVE

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*9099C-1... Allegation: Staff did not prevent a resident from assaulting another resident in care. The allegation states client (C1) has been hit, punched, and kicked by another resident(C2) in the common areas, (R1’s) room and in the shower and that staff are not doing enough to protect (C1).

Facility staff interviews indicated that no one saw the incident that was alleged to have occurred on November 8, 2024 (9:00 am). Both staff also indicated they have never heard or observed (C2) to engage in any physical contact with other residents during the many years (C2) has resided at their care homes. The Administrator stated this is the first time (C1) has bullied (C2). Both staff also indicated (C1)has previously shown this same behavior, including bullying other clients at the residence and day program, and meets with their Behaviorist two times each month.

A lead care staff who was present during the alleged incident stated there was no injury to client, (C2), after client, (C1) placed their backpack on (C2's) feet, adding client, (C2) likes to rest on the front couch often. This staff explained that (C1) came to the kitchen and told her (C2) had kicked them and that (C1) reported it already to the day program. This staff stated "(C1) bullies (C2)" and stated there have been ongoing problems with (C1 and C2) as (C1) doesn't like (C2) walking around as (C2) feels (C1) is "very bossy", commenting (C1) will often "bullies the lower functioning" clients.

(C1) stated to LPA on 11/12/24 that (C1) set their back pack on the couch next to (C2), who was laying on the couch. (C1) stated "(C2) doesn't like anything near (C2)" and asserted "(C2) is violent - (C2) kicked me and slapped me at the kitchen table later on the same day, just to be mean and hateful". Client (C2) stated on 11/12/24 they recall the incident and "(C1)told me to get out of the couch" and indicated they (C2) kicked (C1) but neither was hurt. (C2) has a diagnosis of Dementia, is able to walk without a walker and is more frail than (C1).

(C1's) prior Service Coordinator stated she doesn't know anything about the alleged incident but only knows (C1) from previously working with them, explaining (C1) "has a documented history" of saying people are being mean and bullying her. The current Service Coordinator confirmed there was a quarterly meeting held on 11/18/24 and this alleged incident was discussed. (C1) stated during the meeting that (C1) placed her backpack on client (C2's) feet, while (C2) was laying on the couch. (C2) then moved her feet from under the backpack and kicked (C1). The Service Coordinator stated it was concluded during the meeting that the alleged incident was not "physically possible", as (C2) needs a lot of physical assistance and is very "fragile", and that this was very likely a "misunderstanding" and no physical contact was made.
*cont on 9099C-2..

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024

LIC9099 (FAS) - (06/04)

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Control Number 59-AS-20241108132346

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SUNRISE RESIDENTIAL CARE SERVICES INC. #4	FACILITY NUMBER: 347004534
	VISIT DATE: 12/19/2024

NARRATIVE

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9099C-2...The prior Service Coordinator stated another alleged incident involving (C1) at the day program was captured on camera. The video showed (C1) was hitting another client who attended day program, and not the other way around, as (C1) had described. (C1) still denied hitting the other client, even after being shown the video. This Service Coordinator provided another example involving (C1) and an alleged incident from (C1's) prior care home. (C1) had alleged that all (5) residents were bullying/harassing them, when (2) of the residents were non-verbal and wouldn't have been able to yell at (C1). LPA interviewed a day program manager where (C1) used to attend. This manager reiterated the same tendencies (C1) had to accuse other clients of bullying them, and stated (C1) was the one who bullied other clients. This manager recounted the same alleged incident involving the video on the bus.

LPA interviewed the current day program manager at the program (C1) currently attends. This manager stated that when (C1) started the program, they would report daily that a client in the care home was being mean to them, hitting them and going in their room all the time and staff weren't doing anything about it.
This manager stated (C1) is "much happier now" than a month ago and the Administrator of the care home recently went "above and beyond" to ensure (C1) was able to attend a holiday party last weekend. This manager stated she did observe that (C1) "can be a little mean" at times but feels the house staff are doing more to keep residents in check as (C1) is not complaining anymore and is very happy now

LPA reviewed a progress report from the Regional Center which notes (C1) "exhibits behavior associated with unsolicited verbal directives towards peers, arguing, escalating to attempted or successful physical aggression towards peers (hitting or slapping on arm or hand)." The report notes (C1) began to receive Behavioral Consultation services at her current residents on 7/1/24, in the area of emotional outbursts behavior, related to behavior above. Staff were provided with data sheets to assist with tracking more baseline data to help develop a Behavioral Intervention Plan and to document the antecedents and consequences of the inappropriate or excess behaviors.

A lead staff stated on 12/19/24 (C1's) behavior has significantly improved over the last (2) weeks and has observed more positive interactions between (C1) and the other clients.

Based on information obtained, LPA finds the allegation to be UNFOUNDED- A finding of unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.This allegation is being dismissed without any further action.

Exit interview conducted with lead care staff who was authorized by the Administrator to sign today's report.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024

LIC9099 (FAS) - (06/04)

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