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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 07/07/2020
Date Signed: 07/07/2020 01:50:04 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/27/2020 and conducted by Evaluator Robbie Johnson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200327170519
FACILITY NAME:ATRIA HACIENDAFACILITY NUMBER:
336400075
ADMINISTRATOR:BARTON, ROBERTFACILITY TYPE:
740
ADDRESS:44600 MONTEREY AVETELEPHONE:
(760) 341-0890
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:266CENSUS: 172DATE:
07/07/2020
UNANNOUNCEDTIME BEGAN:
01:22 PM
MET WITH:Robert Barton, AdministratorTIME COMPLETED:
01:49 PM
ALLEGATION(S):
1
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9
Staff not following resident's dietary needs.
Staff did not dispense medication to resident.
INVESTIGATION FINDINGS:
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2
3
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5
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10
11
12
13
Licensing Program Analyst (LPA) Robbie Johnson contacted the facility via telephone to deliver findings regarding the above allegations via telephone due to COVID-19. LPA identified herself and discussed the purpose of the call and the elements of the above allegations with Administrator Robert Barton.

Interviews with the reporting party revealed that staff is not meeting resident's dietary needs. A review of R1's needs and services plan did not reveal that R1 required a special diet. Interviews with staff revealed that when R1 has made a request for food not served at the facility, staff has accommodated the request. LPA could find no evidence that R1 required a special diet that the facilty falied to follow. The allegation is unsubstantiated.
Allegation #2 Interviews with the reporting party revealed that staff did not dispense medication to resident. Interviews with the Administrator revealed that staff has administered medications to R1 per physician's orders. LPA reviewed the Medication and Administration records for R1 along with physician's orders. Medications appear to be dispensed per the order of the physician. LPA could not corroborate that staff did not dispense medication to resident. The allegation is therefore unsubstantiated.
*continued on following page*
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Robbie JohnsonTELEPHONE: (951) 248-0304
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2020
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 18-AS-20200327170519
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ATRIA HACIENDA
FACILITY NUMBER: 336400075
VISIT DATE: 07/07/2020
NARRATIVE
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A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged abuse occurred.

A copy of this report was reviewed with and provided to the Administrator.

SUPERVISOR'S NAME: Efren MalagonTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Robbie JohnsonTELEPHONE: (951) 248-0304
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2