The findings and a $2,500 fine are the result of a June 11 state inspection that cited Sunrise for staff failure to provide meaningful activities, intervention or redirection so the 15 residents did not harm themselves or each other.

The facility has paid the fine, said Sarah Evers, media representative for the McLean, Va. , corporate office of Sunrise Assisted Living Inc.

"We have made significant improvements to address the state's concerns," including hiring a new programming coordinator, she said. The staff has received additional training and retraining, Evers added.

"Families are telling us they are seeing improvement over the past month," she said.

Evers said Sunrise has filed a plan of correction and is confident the state will accept it. The state is reviewing the plan, said Margaret Joseph, director of the Office of Public Affairs for the State Department of Health.

Problems cited by inspectors after the June inspection:

• Missed or undocumented medication administration.
• Failure to document the cause of bruises of several residents.
• Failure to administer or document administration of oxygen prescribed for a resident.
• Failure to document the discharge of a resident.
• Failure to have sufficient, qualified staff present at all times to ensure resident care, facility maintenance, to do laundry and to prepare and serve food.

A resident assessed with high-risk balance problems had fallen 10 times since December, sometimes requiring emergency room care. In February, a physician said the resident needed 24-hour, skilled-level nursing care exceeding 120 days per year.

Sunrise is a licensed residential facility and does not provide skilled care. The director told inspectors the physician had marked on his report the resident's needs could be met in a residential care facility. However, the physician's report also stated: "Failure to have 24-hour nursing care tantamount to adult abuse," inspectors found.

Inspectors wrote there was " . . . no evidence the physician, family or the residential facility had determined the ability to provide the necessary staffing to meet the needs of this resident in a residential setting. "

Soiled disposable briefs, gloves and bed pads were found on the ground, next to an unsecured trash receptacle area. A creek running near the trash disposal area contained litter and a trash bag.

The inspectors reported they saw one resident hit another three times, without any staff intervention. They saw another resident put buttons from a quilt-making activity into her mouth.

One resident's room had a strong urine smell from the resident's Pomeranian dog. The Sunrise executive director told inspectors the resident was unable to routinely walk the dog and she knew the dog urinated on the floor.

Executive director Deb Lambert said she "assumed the resident cleaned the (dog) feces from the floor," the report said.

The Sunrise pet policy states pet care is the duty of "all members of the Sunrise family. "

Sunrise has 51 residents, according to the June survey. Lambert was not available for comment.

Licensed residential facilities are governed only by the state, with no federal jurisdiction as there is over nursing homes. Care is not covered by Medicaid or Medicare.

The 20-year-old Sunrise Assisted Living owns 200 facilities in the United States, Canada and England.