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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 08/25/2025
Date Signed: 08/25/2025 06:12:49 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
08/20/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250820094042
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: 141DATE:
08/25/2025
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Executive Director John O’NeilTIME COMPLETED:
06:15 PM
ALLEGATION(S):
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Staff did not seek timely medical attention for a resident
Staff did not provide healthful accommodations for the residents
Staff mishandled a resident's personal belongings
Staff mishandled a resident's medication
Staff do not provide adequate care and supervision
INVESTIGATION FINDINGS:
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On 8/25/2025, at 11:15 AM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegation above. Upon arrival, the LPA informed Executive Director (ED) Kelli Greene and ED John O’Neil of the purpose for this visit.

The complaint alleges staff did not seek timely medical care for Resident R1.
The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed ED Kelli Greene, who was the ED at the time of the incident. The LPA reviewed the Incident Report submitted to the Department that described the incident. The LPA reviewed R1’s individual service plan showing that R1 was independent and required no additional care. The data collected and analyzed by the LPA shows that staff did seek timely medical care for R1, which does not substantiate 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: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
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-20250820094042
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: 08/25/2025
NARRATIVE
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. . . Continued from LIC 9099

The complaint alleges staff did not provide healthful accommodations for R1.
The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed ED John O’Neil. The LPA reviewed the Resident Monthly Assignment Reports for May, June, and July 2025, which showed that services were being provided by staff. The data collected and analyzed by the LPA shows that staff did provide healthful accommodations for R1, which does not substantiate the allegation.

The complaint alleges staff mishandled R1’s personal belongings.
The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed ED John O’Neil. The LPA reviewed the written statement by Staff S1 describing the incident wherein Witness W2 gave away items from R1’s room. The data collected and analyzed by the LPA shows that staff did not mishandle R1’s personal belongings, which does not substantiate the allegation.

The complaint alleges staff mishandled R1’s medications.
The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed ED John O’Neil. The LPA reviewed the Medication Release forms for R1’s medications. The data collected and analyzed by the LPA shows that staff did not mishandle R1’s medications, which does not substantiate the allegation.

The complaint alleges staff did not provide adequate care and supervision for R1.
The LPA interviewed Witness W1 by phone. At the facility, the LPA interviewed ED John O’Neil. The LPA reviewed the Service Care Plans and the Resident Monthly Assignment Reports for May, June, and July 2025, which showed that services were being provided by staff. The data collected and analyzed by the LPA shows that staff did provide adequate care and supervision for R1, which does not substantiate the allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove it; therefore, the allegations are 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: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2