107202497-1-13-2021-24-AS-MHON-BXA25H-20210114160532

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107202497
Report Date: 01/13/2021
Date Signed: 01/13/2021 10:16:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2020 and conducted by Evaluator Alexandria Walton

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200930141232

FACILITY NAME:	ATRIA FRESNO		FACILITY NUMBER:	107202497
ADMINISTRATOR:	NATASHA HAGOPIAN		FACILITY TYPE:	740
ADDRESS:	1715 E ALLUVIAL AVE		TELEPHONE:	(559) 298-4900
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	100	CENSUS:	DATE:	01/13/2021
		UNANNOUNCED	TIME BEGAN:	09:38 AM
MET WITH:	Executive Director, Eduardo R		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Staff failed to meet the residents needs
Staff failed to safeguard residents’ personal items
Facility in disrepair

INVESTIGATION FINDINGS:

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On 1/13/2021, Licensing Program Analyst (LPA) A. Walton contacted Executive Director (ED), Eduardo Rangel to deliver findings on the above allegations via telephone due to COVID-19 and precautionary measures. LPA introduced self and discussed the purpose of the call with the ED.

During the investigation, LPA conducted interviews and reviewed records.

Interviews revealed that if a resident misses a shower, care staff will document resident missed a shower and care staff would shower the resident when the resident is available. Resident R1 “missed scheduled showers” due to not being in the facility “which was frequently”. R1 received a shower when R1 returned to the facility.

Continued to LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

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

LIC9099 (FAS) - (06/04)

Page: 1 of 4

Control Number 24-AS-20200930141232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: ATRIA FRESNO	FACILITY NUMBER: 107202497
	VISIT DATE: 01/13/2021

NARRATIVE

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Due to COVID-19, meals are delivered to resident apartments. After each meal, care staff would return to the apartment and remove dining trays and empty trash cans. Care staff would also pick up trash off the floor “especially if it was dangerous”.

Records review revealed R1 has a personal property/valuables worksheet signed by the responsible party with “none to declare” written out. A police report was filed on 09/09/2020.

Each apartment has a concealed wire in the back of the air conditioning (A/C) unit, “but, it’s not how the unit works”. ED did not receive reports that the A/C unit was not working and no work order was submitted. Per facility staff, R1 “loved having the front door and sliding door open”. ED stated the A/C “was always working”.

Based on interviews conducted and review of records, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did nor occur.

No deficiencies issued.

An exit interview was conducted with ED. A copy of this report was discussed and provided to ED, Eduardo Rangel via email and an electronic read receipt confirms receiving this document. Facility Representative signature on file.

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2020 and conducted by Evaluator Alexandria Walton

COMPLAINT CONTROL NUMBER: 24-AS-20200930141232

FACILITY NAME:	ATRIA FRESNO		FACILITY NUMBER:	107202497
ADMINISTRATOR:	NATASHA HAGOPIAN		FACILITY TYPE:	740
ADDRESS:	1715 E ALLUVIAL AVE		TELEPHONE:	(559) 298-4900
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	100	CENSUS:	DATE:	01/13/2021
		UNANNOUNCED	TIME BEGAN:	09:38 AM
MET WITH:	Executive Director, Eduardo R		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Facility has roaches

INVESTIGATION FINDINGS:

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On 1/13/2021, Licensing Program Analyst (LPA) A. Walton contacted Executive Director (ED), Eduardo Rangel to deliver findings on the above allegation via telephone due to COVID-19 and precautionary measures. LPA introduced self and discussed the purpose of the call with the ED.

During the investigation, LPA conducted interviews and reviewed records.

The above facility has ongoing monthly pest control service. Facility had all apartments sprayed for roaches by Pest Control. Receipts for proof of services were provided during the complaint investigation.

Continued to LIC9099-C

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

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

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 24-AS-20200930141232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: ATRIA FRESNO	FACILITY NUMBER: 107202497
	VISIT DATE: 01/13/2021

NARRATIVE

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This agency has investigated the complaint alleging: Facility has roaches. We have found the complaint was UNFOUNDED.

No deficiencies issued.

An exit interview was conducted with ED, Eduardo Rangel. A copy of this report was discussed and provided to ED, Eduardo Rangel via email and an electronic read receipt confirms receiving this document. Facility Representative signature on file.

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

LIC9099 (FAS) - (06/04)

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