Complaint Investigation Report

502700653-9-5-2023-27-AS-KHOS-CVLLCC-20230912083807

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

SACRAMENTO AC/SC , 2525 NATOMAS PARK DR. STE.270

This is an official report of an unannounced visit/investigation of a complaint received in our office on

05/15/2023 and conducted by Evaluator Renee Campbell

COMPLAINT CONTROL NUMBER: 27-AS-20230515130640

Facility doorway is not free from obstruction

Food is inaccessible to residents in care.

THIS REPORT IS AN AMENDMENT OF THE VERBIAGE FOUND IN THE PRIOR LIC9099 AND THIS NEW 9099 NOW SUPERSEDES IT.

On 07/24/2023, Licensing Program Analyst Renee Campbell arrived at Sunshine Care Home III to deliver findings for complaint 27-AS-20230515130640. LPA met with Direct Service Providers (DSP) Ramon Howard and Ekoti Ingi, and 15 mins later, met with Administrator Mary Amoah and explained the purpose of the visit. The investigation was conducted by the Department which consisted of a review of records, observations and interviews.

Regarding allegation, "Facility doorway is not free from obstruction", during interviews, staff and administrator admitted that the facility had pushed furniture in front of the door to prevent a resident from leaving at night. In regards to the allegation, "Food is inaccessible to residents in care.", both staff and the administrator confirmed that a chain had been placed around the refrigirator to dissuade residents from accessing it after meals.

Based on interviews with staff and the administrator confirming that allegations were true, the preponderance of evidence standard has been met. Therefore the above allegations are found to be SUBSTANTIATED. per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached LIC-9099D. Appeal rights were provided. An exit interview was conducted, and a copy of the report was provided.