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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600353
Report Date: 07/12/2024
Date Signed: 07/12/2024 05:23:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 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
07/03/2024 and conducted by Evaluator Alona Gomez
COMPLAINT CONTROL NUMBER: 15-AS-20240703135252
FACILITY NAME:ATRIA VALLEY VIEWFACILITY NUMBER:
075600353
ADMINISTRATOR:BINDRA, MONIQUE SFACILITY TYPE:
740
ADDRESS:1228 ROSSMOOR PKWYTELEPHONE:
(925) 937-7300
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY:153CENSUS: 116DATE:
07/12/2024
UNANNOUNCEDTIME BEGAN:
04:30 PM
MET WITH:Maintenance Director, Kaila HomolkaTIME COMPLETED:
05:50 PM
ALLEGATION(S):
1
2
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5
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7
8
9
Staff are not providing residents adequate food service
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
11
12
13
On 7/12/2024 at 4:30 PM, Licensing Program Analyst (LPA) A Gomez arrived unannounced to conduct an initial 10-day complaint investigation and deliver findings in regard to the allegation above. LPA met with Maintenance Director, Kaila Homolka (MD) and explained the purpose of the visit. Executive Director was unavailable and approved MD to sign.

During the visit LPA obtained copies of restaurant menu, bistro menu, and weekly specials menu. LPA toured kitchen and observed food of good quality and variety. LPA also interviewed 2 residents who all stated that they are satisfied with the food service.

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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Yvonne Flores-LariosTELEPHONE: (510) -28-0517
LICENSING EVALUATOR NAME: Alona GomezTELEPHONE: 510-239-1306
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
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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