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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 01/09/2025
Date Signed: 01/09/2025 04:40:24 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
01/09/2025 and conducted by Evaluator James Sampair
COMPLAINT CONTROL NUMBER: 15-AS-20250109115336
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: 142DATE:
01/09/2025
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Executive Director Kelli GreeneTIME COMPLETED:
05:00 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 1/9/2025 at 2:30 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 (MD) James Campers. Both the MD and the ED were familiar with the leak. It is a major project for which they have already gotten a quote and approved the work order to make the necessary repairs that will be completed within 3 weeks. The data collected does not confirm the allegation.

The complaint alleges staff do not ensure that facility is maintained in a sanitary manner.
The LPA interviewed the ED, the MD, and Compliance Director (CD) Patty Hoguin. Based on the statements from the ED and MD concerning the needs of this resident and the services being provided to them on a daily basis, the staff have been working to support the needs of this resident and to maintain the facility in a sanitary manner. 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: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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-20250109115336
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: 01/09/2025
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: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2