336400075-4-19-2022-18-AS-JESL-CDXUQW-20220429154749

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 04/19/2022
Date Signed: 04/19/2022 12:30:57 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, 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
04/13/2022 and conducted by Evaluator Crystal Colvin

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20220413085122

FACILITY NAME:	ATRIA HACIENDA		FACILITY NUMBER:	336400075
ADMINISTRATOR:	BARTON, ROBERT		FACILITY TYPE:	740
ADDRESS:	44600 MONTEREY AVE		TELEPHONE:	(760) 341-0890
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92260
CAPACITY:	266	CENSUS: 141	DATE:	04/19/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Monique Moreira - Assistant Executive Director		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Resident sustained injuries while in care due to neglect

Staff did not respond to resident's call button in a timely manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Crystal Colvin arrived at the facility unannounced for the purpose of investigating a complaint with the above allegation. LPA Colvin met with Assistant Executive Director Monique Moreira and discussed the elements of the complaint. Below is a summary of today's findings:

Regarding allegation "Resident sustained injuries while in care due to neglect": LPA Colvin conducted interviews with staff and reviewed relevant documents in resident’s (R1) file. R1 had an unwitnessed fall in their private apartment on 3/8/22, in which staff responded and contacted emergency services, who then transported R1 to the hospital. R1 sustained facial bruising and skin tear, but no other injuries were noted. Interviews and records show that R1 was Independent and on minimal services (3x daily checks for fall risk). LPA Colvin observed that the status checks for R1 were completed that day by care staff, and that according to interviews R1 fell due to feeling faint or dizzy. Since R1's fall could not have been prevented by facility staff and facility staff completed the required status checks on R1 according to R1's Care Plan, the allegation "Resident sustained injuries while in care due to neglect" is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

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 18-AS-20220413085122

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: 04/19/2022

NARRATIVE

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Regarding allegation "Staff did not respond to resident's call button in a timely manner": LPA Colvin interviewed facility staff and reviewed facility call button response times. The response time log shows three pendant call for 3/8/22 (7:42pm, 7:46pm, & 7:55pm). The first two calls show response times in 3 minutes and 5 minutes, while the third pendant call shows response in 17 minutes. In reviewing the call log with the Assistant Executive Director and Care Service Director, it was unclear who responded to the first two calls, and all persons interviewed by LPA Colvin deny any staff attending to previous calls before the last call at 7:55pm (or knowledge of these calls occurring). The facility maintains a log for the staff pendants in order to identify who responded to each call, however, the pendant that was used on the first two calls had not been signed out for since 3/2/22. All interviews of parties involved maintain that no staff attended to R1 prior to the response to the 7:55pm call, wherein emergency services were called for R1 due to the fall and R1 hitting their head. Since there is conflicting information on when R1 first called for help after the fall and when staff responded, the allegation of "Staff did not respond to resident's call button in a timely manner" is UNSUBSTANTIATED.

A finding of 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 violation occurred.

An exit interview was conducted with Assistant Executive Director Monique Moreira and a copy of the report was provided.

SUPERVISOR'S NAME: Joel Esquivel	TELEPHONE: (951) 248-0312
LICENSING EVALUATOR NAME: Crystal Colvin	TELEPHONE: (951) 204-0848
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

LIC9099 (FAS) - (06/04)

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