075600352-6-29-2022-15-AS-KHOS-CG2MQA-20220705094827

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 06/29/2022
Date Signed: 06/29/2022 03:52:46 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
06/22/2022 and conducted by Evaluator Leslie Ibo

COMPLAINT CONTROL NUMBER: 15-AS-20220622160236

FACILITY NAME:	ATRIA WALNUT CREEK		FACILITY NUMBER:	075600352
ADMINISTRATOR:	TUDDA, BARBARA		FACILITY TYPE:	740
ADDRESS:	1400 MONTEGO		TELEPHONE:	(925) 938-6611
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94598
CAPACITY:	200	CENSUS: 121	DATE:	06/29/2022
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Jeffrey Freeth, Assistant Executive Director		TIME COMPLETED:	04:10 PM

ALLEGATION(S):

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Residents are being overcharged for services

INVESTIGATION FINDINGS:

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On 6/29/2022, Licensing Program Analysts (LPA) L. Ibo arrived unannounced to investigate the above complaint allegation. LPA met with Assistant Administrator, Jeffrey Freeth and explained the purpose of the visit.

During the course of the investigation, LPA L. Ibo obtained information, collected documents, admission agreements, copy of rate increase sent to residents on October 28, 2021 with effective date of January 1,2022.

Based on records review, during the admission the residents and responsible party received and signed admission agreements stating that the facility reserve the right to change rates and any change in fee will be effective in sixty (60) days after notifying the residents or responsible party.

...Continue to LIC9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Harpreet Humpal	TELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Leslie Ibo	TELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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-20220622160236

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: 06/29/2022

NARRATIVE

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Although the residents received increase of the basic service rate, the facility indicated on the notification letter the reason of rate increase and a general description of the additional costs. Admission agreement also included the rate increase history disclosure, which indicated the average monthly rate increase for the previous three years.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided.

SUPERVISOR'S NAME: Harpreet Humpal	TELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Leslie Ibo	TELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC9099 (FAS) - (06/04)

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