317005428-12-29-2022-25-AS-LMUZ-CML2K4-20221229162718

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005428
Report Date: 12/20/2022
Date Signed: 12/29/2022 08:21:32 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2022 and conducted by Evaluator DeAnna Williams-Lyons

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220620155519

FACILITY NAME:	ATRIA ROCKLIN		FACILITY NUMBER:	317005428
ADMINISTRATOR:	DANA STANSEL		FACILITY TYPE:	740
ADDRESS:	3201 SANTA FE WAY		TELEPHONE:	(916) 435-8800
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	105	CENSUS:	DATE:	12/20/2022
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Dana Stansel, Executive Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Allegations: UNSUBSTANTIATED
Facility does not provide a safe environment for residents.
Facility staff members handled residents in a rough manner.
Facility staff do not treat residents with dignity.
Facility staff rush residents to finish their meals.
Residents are given old food and drinks that make them sick.
Residents have unexplained injuries (bruising, skin tears).

INVESTIGATION FINDINGS:

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This report was amended to make 'Public'.
On December 20, 2022, Licensing Program Analysts (LPA) DeAnna Williams-Lyons arrived at the facility unannounced to deliver findings for a Complaint Investigation. LPA conducted COVID-19 Precautionary prescreening and wore a surgical mask while at facility. LPA interviewed 6 residents and 8 staff on 10/19/2022, and 10/20/2022. LPA reviewed facility records for residents. Residents interviewed stated they have no issues with staff. Staff and residents all stated they did not observe an unsafe environment or neglect. Title 22 regulations do not require facilities to keep response times for call buttons so LPA cannot prove or disprove the call response times occurred. Based on there were 2 versions of events during that time frame, the allegations cannot be proved or disproved. Allegations are unsubstantiated

LPA reviewed facility records for residents. Residents interviewed stated they have no issues with staff. Caregivers and residents stated that there were no unexplained injuries at the facility. W1 stated residents had bruises on their arms and legs caused by the rough manner.
To continue see 9099-C..

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons	TELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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 25-AS-20220620155519

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: ATRIA ROCKLIN	FACILITY NUMBER: 317005428
	VISIT DATE: 12/20/2022

NARRATIVE

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LPA did not observe any bruises on R1. Because there are several versions of events, LPA cannot prove or disprove the allegation, therefore, the allegation is unsubstantiated.
LPA reviewed R1's facility file, interviewed caregivers and was unable to interview the resident who moved out due to their injuries. The facility incident report stated the resident was observed earlier in the day attempting to get up without assistance and a caregiver was walking by and was able to assist the resident from getting up. A short time later the caregiver heard a sound come from the resident’s room and found the resident on the floor. The facility records and interviews all state the resident did not have a history of getting out of bed without assistance and would wait for someone to show up to assist after pressing the call button. All caregivers interviewed stated that residents who are identified as fall risks have frequent checks. Residents stated caregivers constantly walk around checking on residents. The regulations require a written plan of care that tells caregivers what residents require assistance with and approximately how often a resident should be checked on. The regulations require the facility to update the plans of care when there is a change in condition or every 12 months; whichever comes first. There are times where a resident requires one-on-one supervision and when that happens the facility may provide the caregiver, or the family may provide the caregiver and there’s a written agreement addressing the issue. LPA cannot prove or disprove the lack of staffing and supervision has caused injuries to residents. Allegations unsubstantiated

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons	TELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2022 and conducted by Evaluator DeAnna Williams-Lyons

PUBLIC

COMPLAINT CONTROL NUMBER: 25-AS-20220620155519

FACILITY NAME:	ATRIA ROCKLIN		FACILITY NUMBER:	317005428
ADMINISTRATOR:	DANA STANSEL		FACILITY TYPE:	740
ADDRESS:	3201 SANTA FE WAY		TELEPHONE:	(916) 435-8800
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	105	CENSUS:	DATE:	12/20/2022
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Dana Stansel, Executive Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Allegations: UNFOUNDED
Toileting and oral hygiene needs are not being met
Residents' maintenance and housekeeping needs are not being met.
Facility did not seek resident care from hospice agency when needed.
Facility staff rush residents to finish their meals.
Residents are given old food and drinks that make them sick.

INVESTIGATION FINDINGS:

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LPA interviewed caregivers and residents regarding toileting needs and oral hygiene needs are not being met. LPA interviewed caregivers who all denied not changing residents. The caregivers stated they changed the residents who required it during the late night/early morning hours and made sure everyone was changed at least once before the shift ended. The caregivers stated they do not leave anyone soiled. LPA interviewed 8 residents and found no complaints. LPA also interviewed housekeeping staff and residents regarding housekeeping needs are not being met. Not one person interviewed said the housekeeping was not being met. All stated their needs are being met. LPA interviewed a medical staff who is also a manager, states the facility does not refer residents to Hospice. They only discuss the change of condition with the family and the family are the ones who will speak to the resident’s physician regarding Hospice. LPA interviewed culinary staff and residents regarding the food that is served. The facility culinary staff stated, “The food comes in fresh, and they serve it fresh daily. None of the residents stated they got sick because of a meal the facility served or they were rushed to complete their meals.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons	TELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

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 25-AS-20220620155519

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: ATRIA ROCKLIN	FACILITY NUMBER: 317005428
	VISIT DATE: 12/20/2022

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Based on observation and interviews conducted, these allegations are Unfounded, meaning the allegations are false, Per California Code of Regulations, Title 22, no citations were issued. An exit interview was conducted, and a copy of this report was given to Dana.

SUPERVISOR'S NAME: Laura Munoz	TELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons	TELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4