306000372-9-18-2024-22-AS-AORZ-D9AQZZ-20240920123734

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306000372
Report Date: 09/18/2024
Date Signed: 09/18/2024 01:02:51 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/02/2024 and conducted by Evaluator Kimberly Lyman

COMPLAINT CONTROL NUMBER: 22-AS-20240802132042

FACILITY NAME:	ATRIA DEL SOL		FACILITY NUMBER:	306000372
ADMINISTRATOR:	GOODWIN, JEREMIAH		FACILITY TYPE:	740
ADDRESS:	23792 MARGUERITE PKWY		TELEPHONE:	(949) 458-1176
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92692
CAPACITY:	120	CENSUS: 95	DATE:	09/18/2024
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Jeremiah Goodwin		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Staff does not provide adequate meal service

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced subsequent complaint visit to continue the investigation into the above allegation. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the memory care unit and interviewed staff and residents. Regarding the allegation that staff does not provide adequate meal service, the investigation revealed the following: LPA observed lunch service. At 11:22 AM, meals were delivered via dumbwaiter. The meal trays were immediately put into warming trays and were observed to be visibly steaming. At 11:41, soup was delivered to tables and LPA observed the soup to be hot at the resident's tables. At 11:55 AM, staff presented the residents with two different meal choices to pick from. At 12:00 PM, the main meals were delivered to resident tables and LPA observed the hot meal choice was hot at delivery. LPA observed no residents in need of eating assistance. Four out of four residents interviewed state caregivers are respectful and food is delivered hot. CONTINUED ON LIC 9099C DATED 09/18/2024

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

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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Control Number 22-AS-20240802132042

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: ATRIA DEL SOL	FACILITY NUMBER: 306000372
	VISIT DATE: 09/18/2024

NARRATIVE

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Based on observations and interviews conducted, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator and a copy of this report was provided to facility.

SUPERVISOR'S NAME: Alisa Ortiz	TELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly Lyman	TELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

LIC9099 (FAS) - (06/04)

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