075600352-10-8-2024-15-AS-KHOS-DAGSUX-20241028141153

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 10/08/2024
Date Signed: 10/08/2024 05:54:48 PM

Unsubstantiated

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
07/11/2024 and conducted by Evaluator Lisha Holmes

PUBLIC

COMPLAINT CONTROL NUMBER: 15-AS-20240711085317

FACILITY NAME:	ATRIA WALNUT CREEK		FACILITY NUMBER:	075600352
ADMINISTRATOR:	KELLI GREENE		FACILITY TYPE:	740
ADDRESS:	1400 MONTEGO		TELEPHONE:	(925) 938-6611
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94598
CAPACITY:	200	CENSUS: 187	DATE:	10/08/2024
		UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Kelli Greene, Executive Director		TIME COMPLETED:	06:30 PM

ALLEGATION(S):

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Staff did not seek medical attention to resident in a timely manner.
Staff does not ensure residents are provided a comfortable temperature.
Staff does not ensure residents are hydrated.
Staff did not accord resident privacy.
Staff does not provide activities.

INVESTIGATION FINDINGS:

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On 10/08/24 around 03:45 PM, Licensing Program Analyst (LPA) L. Holmes arrived unannounced to conduct an initial 10-day complaint visit for the above allegations. LPA met with Kelli Greene, Executive Director (ED) and explained the purpose of the visit.

During the course of the investigation and visits, LPA conducted resident (R1, R5, R7, R8) and staff (ED, S2) interviews. LPA requested the ID/Emergency contact information for five (5) memory care residents along with communication sent to responsible parties regarding visit, and the following documents: Current Personnel Report (LIC 500), LIC 500 dated 05/2024, Resident Roster, email and other communications regarding the air conditioning (AC), Community Event/Activities for the last week of 05/2024, UIR's for heat strokes or dehydration for memory care and assisted living for the last week of 05/2024 and documentation from the HVAC company confirming the AC has been repaired.

Continued on LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Lisha Holmes	TELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 15-AS-20240711085317

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
	VISIT DATE: 10/08/2024

NARRATIVE

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...continued from LIC9099.

For the allegation: Staff did not seek medical attention to resident in a timely manner. Reporting Party (RP) provided two different statements that were conflicting. One statement was that the RP and R9 were in Life Guidance - Memory Care (MC) and saw a woman bleeding while walking and no one could provide care, 911 was called. The second statement was that a woman was in the stairwell bleeding and no one knew the resident was there. RP stated that R9 did not say anything to the staff and later in the conversation RP stated that R9 alerted the front desk. LPA and ADM toured the facility, there was at least six staff available and assisting the residents in MC. The stairwells were secured with an electronic keypad and code for exiting.

For allegation: Staff does not ensure residents are provided a comfortable temperature. Upon arrival on 07/15/24 LPA observed Bay City Maintenance on site monitoring the HVAC system that had been replaced the weekend prior. The temperature in the facility measured at 75 degrees Fahrenheit (F.) in the facility, R7’s room was 74 F., and on 10/08/24 the facility’s temperature was 75 F.

For allegation: Staff does not ensure residents are hydrated. All residents had portable air conditioning units and hydration stations with coolers were in place with chilled water for residents, staff and families.

For allegation: Staff did not accord resident privacy. RP stated that R9 wanted to remain anonymous. LPA could not confirm or deny that R9 was not accorded privacy. R1 stated that sometimes housekeeping knocks lightly, and R1 stated, "Maybe I didn’t hear them but no one entered uninvited".

For allegation: Staff does not provide activities. LPA reviewed the activities calendar for Assisted Living and MC for 07/2024 and 10/2024 that provided a variety of activities. During the visit on 07/15/24, R1 stated that there’s lots of activities: Bingo, exercising, guest speakers, and meals in the community; MC has an activity director that does quite a few things with musicals and singing also. LPA observed the residents engaged and interacting with staff on two occasions during the visit on 10/08/24.

Based on information obtained and observations, the above allegations are UNSUBSTANTIATED and no citations were issued during this visit.

Exit interview conducted, and copy of this report provided to Kelli Greene, Executive Director

SUPERVISOR'S NAME: Yvonne Flores-Larios	TELEPHONE: (510) 286-0517
LICENSING EVALUATOR NAME: Lisha Holmes	TELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

LIC9099 (FAS) - (06/04)

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