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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 02/20/2025
Date Signed: 02/20/2025 02:59:32 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
02/19/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250219133726
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: 150DATE:
02/20/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Executive Director Kelli GreeneTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff does not ensure resident is provided meals.
Staff does not ensure admissions agreement is being followed.
INVESTIGATION FINDINGS:
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On 2/20/2025, at 10:30 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegations above. Upon arrival, the LPA informed Executive Director (ED) Kelli Greene of the purpose of the visit.

The complaint alleges staff does not ensure resident is provided meals.
The LPA interviewed Witness W1 by telephone and in the resident’s room. The LPA reviewed the records concerning the resident, interviewed the ED, Compliance Director (CD) Patricia Hoguin, and interviewed the Resident Services Director (RSD) Risa Austria. The data collected from the interviews and record review shows the resident was provided meals, which 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: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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-20250219133726
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: 02/20/2025
NARRATIVE
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....Continued from LIC 9099

The complaint alleges staff does not ensure admissions agreement is being followed.
The LPA interviewed Witness W1 by telephone and in the resident’s room. The LPA reviewed the resident’s Admission Agreement, interviewed the ED, and interviewed the RSD. The data collected from the interviews and record review shows that the resident’s admission agreement was being followed, which does not confirm the allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove them; 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: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2