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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600352
Report Date: 12/09/2021
Date Signed: 12/09/2021 06:05:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:ATRIA WALNUT CREEKFACILITY NUMBER:
075600352
ADMINISTRATOR:TUDDA, BARBARAFACILITY TYPE:
740
ADDRESS:1400 MONTEGOTELEPHONE:
(925) 938-6611
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:200CENSUS: 111DATE:
12/09/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Barbara TuddaTIME COMPLETED:
06:30 PM
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Licensing Program Analyst (LPA) James Sampair met with Acting Executive Director Barbar Tudda concerning errors in the delivery of medications on 12/05/21 and 12/06/21 to 2 different residents, R1 and R2, by med techs Kulbhushan Rai and Camille Mallari. Ms. Tudda had submitted an LIC624 about each of those errors on 12/08/21.

Upon arrival, LPA explained the purpose of the visit with Ms. Tudda and asked her to share with him details about what had happened. She shared that the circumstances in both cases were similar, but that there was no direct relationship between the 2 occurrences. The major similarity was that in both cases the staff members were new in their role as medical technicians (med techs). During their review of what was missing, the presence of which would make a difference in their future training and preparation for new med techs, Ms. Tudda and the Resident Services Director, Eleasha Brown, LVN, saw that what was missing was something at an ontological level. What was missing was asking the new med techs a simple question, "How are you feeling about being on your own?" The intent of that question is to help to relieve some of the pressure that someone new in that position may be feeling to "look good" to their supervisor by going out on their own even when they are not really ready.

Beyond that important work to increase the effectiveness of their training and development for future newly trained med techs, in the short-term all of the med techs have had a retraining on proper procedures. As far as Mr. Rai, he has chosen to give his 2 week notice and for Ms. Mallari she has been now retrained and will be shadowed further by veteran med techs to complete the final stage of her training as a med tech.

During this visit no deficiencies were cited. An exit interview conducted and a copy of this report was provided to the administrator.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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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