317005428-6-20-2024-59-AS-TORZ-D6VVCM-20240705161922

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 317005428
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:54:40 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2024 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20240502101513

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: 85	DATE:	06/20/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Dana Stansel, Administrator		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff are serving a poor quality of food.
Lack of supervision resulting in resident falling.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to continue investigation into allegations listed above. LPA met with Administrator Dana Stansel during today's inspection.
During the investigation LPA toured the facility, dining room, and kitchen. LPA observed 2-day perishable, 7-day non-perishable amount of food. LPA observed fresh fruits and vegetables being served to residents. LPA was present during a lunch serving, and food appeared to be warmed with a variety of food available to residents. In the kitchen the staff utilize warming trays and a heat lamp to ensure food stays warm during serving. LPA interviewed 5 residents and 7 staff members.
Continuation on 9099-C.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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 59-AS-20240502101513

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: ATRIA ROCKLIN	FACILITY NUMBER: 317005428
	VISIT DATE: 06/20/2024

NARRATIVE

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Resident interviews indicated there is always a sufficient amount of food being served. There are fresh fruits and vegetables being served, and 4 of 5 residents indicate a variety of food choices available to residents. Resident interviews indicate at times the food will not be warm enough but staff will reheat food if requested. Staff interviews indicate that a variety of food is offered to residents, and fruits and vegetables are always available. Staff interviews indicate they have heard complaints about the temperature of the food, but they are always available to reheat if needed. Due to the information gathered, LPA finds allegation to be UNFOUNDED.

LPA investigated allegation, "Lack of supervision resulting in resident falling". Relevant party indicated there is a lack of staff available to residents in need. Relevant party indicated that a resident had a fall during the day hours and staff responded quickly. Relevant party had concerns if the fall occurred during the night hours if the staff would have been able to respond quickly. LPA interviewed 5 residents and 5 care staff. Of the 5 residents interviewed, they required care and supervision. Residents stated they have had no falls due to a lack of supervision. LPA interviewed staff in which they all stated they are not aware of any resident having a fall due to a lack of supervision. Staff indicated they have sufficient staff to meet the needs of the residents in care. Due to the information gathered, LPA finds allegation to be UNFOUNDED.

A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2024 and conducted by Evaluator Bethany Mirlohi

COMPLAINT CONTROL NUMBER: 59-AS-20240502101513

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: 85	DATE:	06/20/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Dana Stansel, Administrator		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff does not provide assistance to resident(s) in a timely manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to continue investigation into allegation listed above. LPA met with Administrator Dana Stansel during today's inspection.
LPA investigated allegation, "Staff does not provide assistance to residents in a timely manner". Relevant party indicated there is a lack of staff to provide assistance to residents needing care. Relevant party stated they have observed residents waiting for 30 minutes when needing care. Relevant party indicates a resident has had issues with receiving timely care when it's concerning continence care. LPA interviewed 5 residents in care and 5 care staff. Residents indicated they personally have not had issues with staff responding in a timely manner to provide care.
Continuation on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

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 59-AS-20240502101513

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833

FACILITY NAME: ATRIA ROCKLIN	FACILITY NUMBER: 317005428
	VISIT DATE: 06/20/2024

NARRATIVE

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2 of 5 residents indicated they have observed residents waiting for care when needing escorts back to their rooms. Residents interviewed stated there is enough staff available to meet their care needs. Staff interviews indicated they have sufficient care staff to meet resident needs. Staff stated they work as a team and if caregivers are performing care and a resident needs help, a med tech or manager will check on the resident. Staff stated at times they have call offs but they are able to meet the needs of the residents. Staff stated that residents can get a hold of them by pushing a pendant, calling the front desk by using the "Alexa" in their room, or by using their pull cord for emergencies.

Due to the information gathered, LPA finds allegation to be UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations occurred, and the findings are unsubstantiated.

Exit interview conducted and copy of report provided.

SUPERVISOR'S NAME: Troy Ordonez	TELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany Mirlohi	TELEPHONE: (916) 204-8288
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4