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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604607
Report Date: 02/15/2024
Date Signed: 02/15/2024 04:00:06 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/09/2024 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20240109135721
FACILITY NAME:SUNSET RESIDENTIAL CARE IFACILITY NUMBER:
374604607
ADMINISTRATOR:LOPEZ, YANET PUENTESFACILITY TYPE:
740
ADDRESS:2707 NANSEN AVETELEPHONE:
(858) 352-6340
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
02/15/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Administrator Yanet PuentesTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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Uncleared staff
Staff do not have required training
INVESTIGATION FINDINGS:
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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
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 08-AS-20240109135721
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SUNSET RESIDENTIAL CARE I
FACILITY NUMBER: 374604607
VISIT DATE: 02/15/2024
NARRATIVE
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 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.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 08-AS-20240109135721
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: SUNSET RESIDENTIAL CARE I
FACILITY NUMBER: 374604607
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/15/2024
Section Cited
CCR
87355(e)(1)
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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:
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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.
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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.
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Type B
02/15/2024
Section Cited
CCR
87411(c)
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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:
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Adminitrator agreed to provide the LPA documentation of staff trainings for S3, S4, and S5, by 3/15/24.
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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.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/09/2024 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20240109135721

FACILITY NAME:SUNSET RESIDENTIAL CARE IFACILITY NUMBER:
374604607
ADMINISTRATOR:LOPEZ, YANET PUENTESFACILITY TYPE:
740
ADDRESS:2707 NANSEN AVETELEPHONE:
(858) 352-6340
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
02/15/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Administrator Yanet PuentesTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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2
3
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9
Staff are unable to communicate with residents
INVESTIGATION FINDINGS:
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9
10
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13
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. The administrator 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 staff were unable to communicate with residents. It was reported to the Department staff did not speak English and could not communicate with residents. Interviews with internal and external sources did not reveal any concerns with lack of communication, nor understanding from staff. Although, some staff may not speak English fluently, sources had witnessed staff responding and meeting the residents’ requests. Based on the evidence obtained, there was not a preponderance of evidence to prove the alleged violation occurred.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 08-AS-20240109135721
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: SUNSET RESIDENTIAL CARE I
FACILITY NUMBER: 374604607
VISIT DATE: 02/15/2024
NARRATIVE
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3
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5
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7
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An exit interview was conducted with Administrator Puentes, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5