197608685-10-31-2022-31-AS-RRAZ-CL3N7S-20221111091310

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608685
Report Date: 10/31/2022
Date Signed: 10/31/2022 02:55:48 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, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2022 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20221027112508

FACILITY NAME:	ATRIA SANTA CLARITA		FACILITY NUMBER:	197608685
ADMINISTRATOR:	JOHNNY ORTIZ		FACILITY TYPE:	740
ADDRESS:	24431 LYONS AVE		TELEPHONE:	(661) 254-9933
CITY:	SANTA CLARITA	STATE: CA	ZIP CODE:	91321
CAPACITY:	160	CENSUS: 114	DATE:	10/31/2022
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Johnny Ortiz		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff not providing assistance to residents in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to investigate the above allegations. LPA met with the Executive Director (ED), Johnny Ortiz, and discussed the reason for the visit.

--- Facility staff not providing assistance to residents in a timely manner.

It was alleged that the residents are waiting a long period of time because the facility is understaffed. To investigate the allegation, on 10/31/2022 at 10:45 AM, LPA requested records, at 12:00 PM, LPA interviewed residents, at 1:45 PM, LPA made observations and, at 2:00 PM, LPA interviewed staff. Record reviews show that in the past seven days the call button was used two hundred sixty four times (264), the average response time was seven minutes (07) and there is at least one caregiver per floor per shift caring for an average ten (10) residents per floor in the Memory Care building and twenty eight (28) in the Assisted Living building.
(Cont. on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2022

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 31-AS-20221027112508

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ATRIA SANTA CLARITA	FACILITY NUMBER: 197608685
	VISIT DATE: 10/31/2022

NARRATIVE

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During interviews with residents, they all stated that they do not feel that the facility is understaffed and that the response times for assistance are not long. Furthermore, LPA pushed resident #3's (R3) call button and observed that staff responded within three (03) minutes. During interviews with staff, they all stated that they do not feel the facility is understaffed, that no matter how busy the staff are, there is always someone available to assist residents and the average response times to the call buttons are between five (05) to ten (10) minutes. Based on interviews, record reviews and observations, there is not enough information to verify the allegation, therefore, the allegation is unsubstantiated at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2022

LIC9099 (FAS) - (06/04)

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