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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 07/08/2024
Date Signed: 07/08/2024 02:15:22 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/28/2024 and conducted by Evaluator Kelly Nguyen
COMPLAINT CONTROL NUMBER: 15-AS-20240628093919
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: 154DATE:
07/08/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Kelli Greene, Excutive Director TIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Facility air conditioner is in disrepair.
INVESTIGATION FINDINGS:
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On 07/08/2024 at 10:15 AM Licensing Program Analyst K. Nguyen arrived unannounced to conduct a complaint investigation for the above allegation. LPA met with Executive Director (ED), Kelli Greene, and explained the purpose of the visit.

Allegation: Facility air conditioner is in disrepair: Substantiated
During the course of the investigation, LPA interviewed staffs.It was alleged that Facility air conditioner is in disrepair, based on interview with ED the facility air condition was in disrepair since end of May and is in the process of being fix. ED stated that they are waiting for part from a third part vendor that created this main chiller (air conditionor), and there are no other places that we can purchase these parts from. We are working with the vendor to get this main chiller fix as soon as possible. LPA observed the thermostats on the first floor was at 89 degree Fahrenheit.

Based on LPA interviews and observation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8), are being cited on the attached LIC 9099 D.

Exit interview conducted. A copy of this report and appeal rights provided via email.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Kelly NguyenTELEPHONE: (510) 915-8702
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
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-20240628093919
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: ATRIA WALNUT CREEK
FACILITY NUMBER: 075600352
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2024
Section Cited
CCR
87303(b)
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(b) A comfortable temperature for residents shall be maintained at all times.

(1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C).

(2) The facility shall cool rooms to a comfortable range, between 78 degrees F (26 degrees C) and 85 degrees F (30 degrees C), or in areas of extreme heat to 30 degrees F less than the outside temperature.

(3) Nothing in this section shall prohibit residents from adjusting individual thermostatic controls.


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Executive Director will continue to follow-up with the third-party vendor regarding the missing parts. Executive Director agrees to fix the air conditioner and submit confirmation to CCLD of the air condition fully working condition by POC date.
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-This requirement is not met as evidenced by:

Based on interview with ED the facility air condition was in disrepair since April and is in the process of fixing. LPA observed the thermostats on the first floor was at 89 degree Fahrenheit. Which posed a potential health & safety risk to residents in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Bennett FongTELEPHONE: (510) 725-7919
LICENSING EVALUATOR NAME: Kelly NguyenTELEPHONE: (510) 915-8702
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2