Sunrise Assisted Living of Fair Oaks.

During visit conducted on April 22, 2025, LPA conducted a medication count for residents R1, R2, and R3, comparing the residents’ Centrally Stored Medication Forms (CSM) with medications centrally stored for the residents. LPA observed one (1) medication for R1 to be over the amount documented in R1's CSM. Facility was unable to provide any documentation to explain why R1's medication was over the amount documented. LPA observed Medication Administration Record (MAR) for R1, which indicated that medication was administered every day since start date documented and no tabs were missed. LPA observed one (1) medication for R3 to be over the amount documented in R3's CSM. Facility was unable to provide any documentation to explain why R3's medication was over the amount documented. LPA observed MAR for R3, which indicated that medication was administered every day since start date documented and no tabs were missed. LPA observed CSMs for R3's medication dating back to November 2024 and observed that R3's medication had gaps of several days between each refill. Facility was unable to provide documentation to explain the gaps of several days in which R3 was not provided medication between each refill. Based on a medication count, observation, and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D page. A civil penalty in the amount of $250 is assessed for April 23, 2025 for a repeat violation within 12 months of a prior violation of a statutory or regulatory provision designated by the same combination of letters or numerals per Health and Safety Code §1548. Exit interview was conducted with ED. A copy of this report and appeal rights were provided. ED's signature on these forms acknowledges receipt of these documents. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Interviews with staff members S1, S2, S3, and residents R4, R5, R6, and R7 indicated that they have never observed the facility to be malodorous. Interview with ED indicated that, since starting at the facility, they have never observed the facility to be malodorous. During visits conducted on April 22, 2025 and April 23, 2025, LPA toured the premises, including the Memory Care Unit (MCU), and did not observe facility to be malodorous. Allegation: Staff does not ensure facility is clean. Interviews with S1, S2, S3, R4, R5, R6, and R7 indicated that they have never observed the facility to be unclean. Interviews with S1, S2, and S3 indicated that the facility does a good job with providing incontinence care to residents and ensuring facility is clean in case of an accident. Interview with ED indicated that, since starting at the facility, they have never observed the facility to be unclean. During visits conducted on April 22, 2025 and April 23, 2025, LPA toured the premises, including the MCU, and did not observe facility to be unclean. Based on interviews conducted and observations, the preponderance of evidence standards have not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. A finding that a complaint allegation is unsubstantiated means that, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Exit interview was conducted with ED. A copy of this report was provided. Signature on these forms acknowledges receipt of these documents.

Licensing Program Analyst (LPA) Michael Hood arrived at the facility unannounced on 3/26/25 to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed five (5) apartments in Assisted Living, four (4) apartments in Memory Care, and three (3) common area bathrooms. LPA conducted interviews with four (4) residents and three (3) staff during inspection. LPA observed apartments to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition, properly maintained, and the hot water temperature was observed to be 116.6 degrees F. LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two-day perishable and (7) seven-day non-perishable food supply on hand. LPA observed the perimeter of the care home to be free of clutter and debris. LPA ensured that delayed egress in Memory Care was operational. Smoke detectors and carbon monoxide detectors are hard wired in the care home. Fire extinguishers are maintained and ready for emergency use. First aid kit is maintained and ready for emergency use. LPA checked medication storage and found medication to be locked away and inaccessible to the residents. LPA reviewed two (2) residents' medications, five (5) resident files and three (3) staff files. Facility has a current copy of certificate of liability insurance and LPA requested a copy. As a result of today's visit, a deficiency is being cited per California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiency is listed on the attached 809-D page. Exit interview was conducted with ED. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.

Licensing Program Analysts (LPAs) Michael Hood and Cassie Mikkelson arrived at the facility and met with Senior Executive Director (SED), Cortez Jordan, to issue a citation in relation to a separate inspection. During inspection conducted on 10/16/2024, it was observed that resident (R1) sustained multiple falls at the facility. Two of the falls resulted in injury according to Post Fall Evaluations provided. LPAs requested Unusual Incident Reports (SIRs) for R1's falls. Facility could not produce and supply LPAs with requested SIRs during visit. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 809-D page regarding reporting requirements. Exit interview was conducted with SED. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.

Interviews with residents R1, R2, R3, R4, and relevant party indicated that the facility does not have sufficient staff to meet the residents' care needs. R1 stated that they've had to wait about an hour for a response from care staff with their call button. R1 stated that there are too many residents in need for staff to care for and they don't get enough time to care for the residents. R2 stated that there are a lot of residents in need of assistance and some caregivers are pulling two wheelchairs at the same time. R2 stated that caregivers cannot spend enough time with residents because there are too many residents in need of assistance for the amount of caregivers on shift. R3 stated response times to call buttons are never ten (10) minutes and they've had to wait an hour for assistance after sustaining a fall. R4 stated that management reduced the amount of staff on duty at any given time and has had to wait an hour for a response to their call button. Interv iew with relevant party indicated that caregivers don't even have enough time to talk with residents and are stretched thin. Relevant party stated that staff want to provide care to residents, but just can't due to there not being enough staff on duty. Interviews with staff members S1, S3, and S4 indicated that standard response times to resident call buttons should be within ten (10) minutes. Interview with S1 indicated that R1 has had to wait forty-five (45) minutes to receive assistance to the dining room due to S1 needing to provide care to other residents. Interview with staff member (S2) indicated that they can take fifteen (15) to twenty-five (25) minutes to respond to a call button. S2 stated that there are a lot of residents who need assistance from staff and they can't "do everything at once." S2 stated that they may not have time to respond to a call button due to providing care to someone else. S2 stated that they feel staffing is "terrible" at the facility. Interview with S3 indicated that staff get busy and can't assist residents timely. S3 stated that they feel the facility is short on staffing. Interview with S4 indicated that "everything" is not being responded to timely and they "definitely" feel there should be more staff on duty. ** Report continued on 9099-C ** 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 LPAs obtained and observed facility's Emergency Needs Response, which states "response call logs are reviewed at community morning meetings and monthly Quality Assurance meetings. All calls exceeding a 10 minute time response will be reviewed further." LPAs observed call button logs for resident R1, R2, R3, R4, R5, R6, R7, R8, and R9 for the month of September 2024. LPA observed multiple call button response times exceeding 10 minutes and reaching as long as 419 minutes. LPAs toured the facility and observed that it took 12 minutes to walk the interior and exterior parameter of the care home. Based on interviews conducted and records reviewed, the preponderance of evidence standards have been met. Therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D page. Exit interview was conducted with ED. A copy of this report and appeal rights were provided. ED's signature on these forms acknowledges receipt of these documents.