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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600352
Report Date: 04/24/2024
Date Signed: 04/24/2024 04:57:56 PM


Document Has Been Signed on 04/24/2024 04:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612



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: 131DATE:
04/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Executive Director Kelli GreeneTIME COMPLETED:
05:00 PM
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On 4/24/2024 at 3:00 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct the Required Annual Inspection of the facility. Upon arrival, LPA stated the purpose of the visit to Executive Director (ED) Kelli Greene.

The LPA inspected the physical plant with the ED and Maintenance Director Matthew Maroquin. In the Assisted Living and Memory Care areas they examined the kitchens, dining areas, restrooms, community living spaces, resident rooms, and storage. For the inspection of the exterior of the facility, the LPA examined the fish ponds that are made inaccessible to residents with wire fencing and the delayed egress of the Memory Care. In the kitchen, more than the required minimum of 7 days of nonperishable and 2 days of perishable foods were appropriately stored. Fire extinguishers were last serviced on 5/25/2023 and the latest outside inspection of the fire suppression system was completed 3/22/2024.

The LPA, ED, and Compliance Director Patricia Hoguin examined the chemical storage areas in the first and second floor kitchens of Memory Care, and the Bistro and Main Kitchen on the first floor, and Housekeeping on the fourth floor. The LPA observed postings in the facility that included a complaint poster, Ombudsman and Personal Rights posters, Theft and Loss Policy, Rights to Resident Council, and Rights to Family Council.

An administrator is on site more than the minimum of 20 hours a week to oversee the proper business operations.

The annual inspection is not complete and the LPA will return to complete it at a later date.

No citations issued during the inspection.

Exit interview conducted and a copy of this report provided.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 529-9416
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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