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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306000752
Report Date: 10/23/2025
Date Signed: 10/23/2025 04:43:08 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
08/27/2025 and conducted by Evaluator Andrea Mendivil
COMPLAINT CONTROL NUMBER: 22-AS-20250827083931
FACILITY NAME:ATRIA GOLDEN CREEKFACILITY NUMBER:
306000752
ADMINISTRATOR:JAMES D. CRADDOCKFACILITY TYPE:
740
ADDRESS:33 CREEK RDTELEPHONE:
(949) 786-5665
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:155CENSUS: 120DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Jeremy Gilmore - Executive Director TIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Facility lacks staffing in which resident needs are not being met.
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Andrea Mendivil made an unannounced visit to deliver complaint findings. LPA was greeted and granted entry into the facility and explained the reason for the visit.

The Department received a complaint on 08/27/2025 and LPA Mendivil conducted the initial 10 day visit 09/04/2025. LPA interviewed staff and residents and obtained copies of caregiver schedule for September/October 2025, admission agreement, cleaning/laundry schedule. Regarding the allegation facility lacks staffing in which resident needs are not be met the investigation revealed the following:

It was alleged there is not enough staff to meet residents needs. Based on interviews with staff and Executive Director Jeremy Gilmore, there are about 35-40 residents that have care plans with varying levels of assistance needed in Assisted Living. Executive Director Jeremy stated there are 3 caregivers and 1 med-tech scheduled for AM shift and PM shift in Assisted Living and 2 caregivers and 1 med tech for overnight.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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 2
Control Number 22-AS-20250827083931
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 GOLDEN CREEK
FACILITY NUMBER: 306000752
VISIT DATE: 10/23/2025
NARRATIVE
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Based on interviews with 6 out of 6 residents stated their needs are being met. LPA Mendivil interviewed 5 out of 5 caregiving staff and they all stated they are able to meet residents needs. 5 out of 5 staff stated they answer pendant calls in under 10 mins and there has not been a time when staff has left a resident soiled for an extended period of time. 5 out of 5 staff stated they are trained annually regarding providing assistance with activities of daily living.

Therefore based on the preponderance of evidence through interviews the allegation that Facility lacks staffing in which resident needs are not being met is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

No deficiencies cited.
An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Andrea Mendivil
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2