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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336400075
Report Date: 11/17/2022
Date Signed: 11/17/2022 04:08:57 PM


Document Has Been Signed on 11/17/2022 04:08 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 HACIENDAFACILITY NUMBER:
336400075
ADMINISTRATOR:BARTON, ROBERTFACILITY TYPE:
740
ADDRESS:44600 MONTEREY AVETELEPHONE:
(760) 341-0890
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:266CENSUS: 144DATE:
11/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:SENIOR EXECUTIVE DIRECTOR, SABRINA TUCKER.TIME COMPLETED:
04:30 PM
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On November 17, 2022, Licensing Program Analyst (LPA), Venus Mixson arrived unannounced to conduct a Case Management Health and Safety visit. LPA Mixson was greeted and granted entry by Sabrina Tucker, Senior Executive Director and explained the purpose of the visit.

LPA Mixson interviewed Executive Director and requested and received pertinent documentation. LPA Mixson toured the facility inside and out. At the time of the visit there were 143 residents and 80 facility staff. There are no imminent health and/or safety concerns observed at the time of visit. LPA Mixson observed facility utilities to be on and operating without issue. There was a sufficient amount of staff present at the facility to provide care. All daily activities were going forth as usual without interruption. LPA Mixson assessed the available food supply and observed that the supply exceeds the requirement of a two day supply of perishable foods and a seven day supply of non-perishable foods. Medications were found to be in sufficient supply as well. LPA Mixson inquired about the supervision and/or assessment of residents for future concerns or issues or occarance. Director stated that all residents within the independent care units received three status checks per day.

Based on the information obtained during today's visit, there are no immediate threats to the health, safety, and welfare of the residents in care.

An exit interview was conducted and a copy of this report, along with the LIC 811, was provided to Administrator.

SUPERVISOR'S NAME: Jazmond D HarrisTELEPHONE: (951) 248-0318
LICENSING EVALUATOR NAME: Venus MixsonTELEPHONE: (951) 897-7936
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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