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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 075600353
Report Date: 05/02/2023
Date Signed: 05/02/2023 05:41:38 PM


Document Has Been Signed on 05/02/2023 05:41 PM - It Cannot Be Edited

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 VALLEY VIEWFACILITY NUMBER:
075600353
ADMINISTRATOR:KELLI L GREENEFACILITY TYPE:
740
ADDRESS:1228 ROSSMOOR PKWYTELEPHONE:
(925) 937-7300
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94595
CAPACITY:153CENSUS: 101DATE:
05/02/2023
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Interim Executive Director Kawana AnthonyTIME COMPLETED:
05:45 PM
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On 05/02/2023 at 3:15 PM, Licensing Program Analyst (LPA) J Sampair arrived unannounced for a visit concerning the gastrointestinal (GI) outbreak at the facility reported on 05/01/2023. Upon entry, LPA explained purpose of the visit to Interim Executive Director (IED) Kawana Anthony, National Operations Specialist for Atria Senior Living.

IED Anthony provided information to LPA Sampair on the current status of the outbreak and the measures being taken at the facility to stop its spread and to care for residents. At that time, a total of 11 residents were ill with the Norovirus (2 of whom had been hospitalized and back at tacility). At approximately 3:50 PM, Resident Services Director (RSD) Joanne Bustos joined them to provide additional information. No new cases had been reported since noon, and unlike the GI outbreak reported in 02/28/2023 no staff members had been infected.

The Department of Public Health has been notified. To help stop the spread of the infection, staff and residents are masking. They have stopped group dining and group activities. Residents are being served meals in their room.

No citations issued during visit.

Exit interview conducted with IED and a copy of this report provided via email.
SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: James SampairTELEPHONE: (510) 286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2023
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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