336400075-6-29-2025-18-AS-RORN-DKWNZZ-20250826105509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 06/29/2025
Date Signed: 06/29/2025 05:10:19 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 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
08/16/2022 and conducted by Evaluator Wendy Gibbs

COMPLAINT CONTROL NUMBER: 18-AS-20220816144334

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: 181	DATE:	06/29/2025
		UNANNOUNCED	TIME BEGAN:	08:03 AM
MET WITH:	Teresa Ramirez		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility billed resident for services not being provided.

INVESTIGATION FINDINGS:

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On 06/29/2025, Licensing Program Analyst (LPA), Wendy Gibbs, conducted an unannounced Complaint Visit to the facility listed above. LPA met with Business Office Director, Teresa Ramirez and the purpose of today’s visit was explained. LPA was granted entry into the facility.

The investigation consisted of the following:
On 01/22/2024, LPA Goodrich conducted an initial visit to the facility listed above. During that visit, LPA Goodrich received residents’ Functional Needs Assessments and a monthly billing statement for three residents.
During subsequent visit conducted on 06/28/2024, LPA Gibbs, interviewed Staff S1-S9, interviewed Residents R3-R12, and received documents pertinent to the investigation. The following documents were received and reviewed, Physician’s Report, Physician Orders, Functional Needs and Assessment, and billing statements for resident R2.
The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2025

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-20220816144334

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: ATRIA HACIENDA	FACILITY NUMBER: 336400075
	VISIT DATE: 06/29/2025

NARRATIVE

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Allegation: Facility billed resident for services not being provided.
The allegation alleges that resident is being charged for services that are not being provided to the resident.

LPA received and reviewed R2’s Physician’s Report (dated 09/21/2021) that indicates R2 is able to manage own medications. LPA received and reviewed a letter from the facility to R2’s physician (dated 06/09/2022) that indicates R2 is not compliant with managing own medications. Additionally, the letter indicates a care conference was conducted on 06/08/2022 with R2’s spouse and son regarding R2’s increase in falls, hospital visits, and medications not being refilled or picked up on time. LPA received and reviewed R2’s Needs and Service Plan (dated 09/09/2022) that indicates R2 receives stand-by assistance with transfers due to frequent falls, medication assistance with medication administration two (2) times a date. LPA observed billing statements are consistent with level of care R2 was receiving.

Additionally, LPA received and reviewed the care plan and billing for three (3) residents and observed three (3) out of three (3) residents Care Plan and Billing Statement are consistent with services received.
During interviews with Staff S1-S9, were asked if residents are paying for services they are not provided, nine (9) out of nine (9) stated no, residents do not pay for services they do not receive.
During interviews with Residents R3-R11, were asked if they have been charged for services they do not receive, one (1) out of ten (10) stated they have been charged for services they do not receive. Additionally, the resident stated they took it to management and the charge was removed right away.

During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

During today’s visit, LPA did not observe or cite any deficiencies.

An exit interview was conducted with Business Office Director, Teresa Ramirez and a copy of this report was provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Wendy Gibbs
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2025

LIC9099 (FAS) - (06/04)

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