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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 12/26/2024
Date Signed: 12/26/2024 03:34:40 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/24/2024 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20241224092714
FACILITY NAME:ATRIA WALNUT CREEKFACILITY NUMBER:
075600352
ADMINISTRATOR:KELLI GREENEFACILITY TYPE:
740
ADDRESS:1400 MONTEGOTELEPHONE:
(925) 938-6611
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:200CENSUS: 143DATE:
12/26/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Executive Director Kelli GreeneTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff do not ensure that facility is maintained in good repair.
Staff do not ensure that facility is maintained sanitary.
INVESTIGATION FINDINGS:
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On 12/26/2024 at 1:00 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to conduct this initial 10-day complaint investigation concerning allegations above. LPA met with Executive Director (ED) Kelli Greene and informed her of the allegations.

The complaint alleges staff do not ensure that facility is maintained in good repair.
The LPA interviewed the ED and Maintenance Director James Campers, both of whom stated that anytime there is a clogged toilet, Roto-Rooter is called and the repair is made as soon as possible. The data collected does not confirm the allegation.

The complaint alleges staff do not ensure that facility is maintained in a sanitary manner.
Based on the statements from the ED and Maintenance Director concerning the history of clogged toilets in the facility, especially since all of the toilets were replaced a month earlier, there was no evidence that any toilets were clogged and left unrepaired for more than one day. The data collected does not confirm the allegation.

Continued on LIC 9099-C . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
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 2
Control Number 15-AS-20241224092714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: ATRIA WALNUT CREEK
FACILITY NUMBER: 075600352
VISIT DATE: 12/26/2024
NARRATIVE
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....Continued from LIC 9099

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2