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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361880681
Report Date: 08/08/2023
Date Signed: 08/08/2023 11:57:09 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/31/2023 and conducted by Evaluator Amber Coleman
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20230731195356
FACILITY NAME:SUNSHINE BOARD & CAREFACILITY NUMBER:
361880681
ADMINISTRATOR:HAMED, NAJEHFACILITY TYPE:
740
ADDRESS:720 N LINDEN AVETELEPHONE:
(786) 219-6008
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:12CENSUS: 10DATE:
08/08/2023
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Tyrone Powell, Staff MemberTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Staff engaged in a physical altercation with resident in care.
Staff engaged in a verbal altercation with resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst, Amber Coleman, (LPA) arrived at the Sunshine Board & Care facility unannounced to initiate a complaint investigation into the allegations listed above. LPA knocked on the front door. LPA greeted by Staff Member, Tyrone Powell. LPA introduced self and stated purpose of the visit. LPA asked to enter facility and was granted entry. Staff informed LPA Administrator is not at the facility. LPA contacted Administrator to inform him of the complaint investigation. Administrator agreed to meet LPA during visit.

Today's visit consisted of staff and resident interviews, a walk through of the facility and record reviews.
It is alleged that staff engaged in a physical altercation with a resident in care. Resident interviews revealed that all residents deny witnessing a physical altercation between staff and a resident. During staff interviews, it was discovered that the facility cares for residents with confusion, memory impairment, aggressive behaviors. Staff do have training in engaging with difficult residents. Staff denied witnessing and or engaging in a physical altercation between residents or staff. Staff denied having knowledge of any physical altercations between any residents in care. Please see LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
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 56-AS-20230731195356
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: SUNSHINE BOARD & CARE
FACILITY NUMBER: 361880681
VISIT DATE: 08/08/2023
NARRATIVE
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It is alleged that staff engaged in a verbal altercation with a resident in care. Resident interviews revealed that there was observation of staff speaking to residents in a loud tone, it is not known what specifically was said or the reason for it, only that the volume of the voice was as loud as yelling. Staff reported a verbal altercation between a resident and staff. It was reported that the resident was the aggressor and may have been under the influence. Police were contacted and made a visit. Police determined there was no action to be taken due to the resident's behavior.

Based on observations and interviews, these allegations are UNSUBSTANTIATED. A finding of UNSUBSTANTIATED means 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.
An exit interview was conducted, where this report was reviewed, discussed then provided facility representative.
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Amber Coleman
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC9099 (FAS) - (06/04)
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