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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 07/12/2025
Date Signed: 07/12/2025 05:14:23 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
12/22/2023 and conducted by Evaluator Alfonso Iniguez
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20231222144402
FACILITY NAME:ATRIA HACIENDAFACILITY NUMBER:
336400075
ADMINISTRATOR:ROBERT STANSBURYFACILITY TYPE:
740
ADDRESS:44600 MONTEREY AVETELEPHONE:
(760) 341-0890
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:266CENSUS: 90DATE:
07/12/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Nathan Boese/Assistant Executive DirectorTIME COMPLETED:
04:50 PM
ALLEGATION(S):
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Staff do not provide resident with housekeeping services.
Staff are not addressing pests at the facility.
INVESTIGATION FINDINGS:
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On 7/12/2025 at approximately 8:30 AM, LPA Alfonso Iniguez conducted a subsequent unannounced complaint visit. LPA Iniguez met with Nathan Boese/Assistant Executive Director. LPA Iniguez explained the purpose of this visit.


Investigation Consisted of: LPA conducted the following interviews: Assistant Executive Director Interview (A#1), Residents Interviews (R#1-R#9) and Staff Interview (S#1-S#4). LPA obtained and reviewed the following documents: Resident Roster dated: 7/12/25, Staff Roster dated: 7/12/25, Copy of (PR#1)’s Service Agreement dated:8/23/2018, Copies of Facility Housekeeping schedule, and copies from pest control company invoices dated: 7/2024 through 5/2025.

Evaluation Report continues LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2025
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 18-AS-20231222144402
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: 07/12/2025
NARRATIVE
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Investigation Revealed the Following:

Allegation: Staff do not provide resident with housekeeping services.

The details of the complaint alleged that facility staff is not cleaning (R#1)’s room.



On July 12, 2025, at approximately 2:00 PM, during a Health and Safety check of the facility, LPA Iniguez, along with (A#1), toured the premises. (6) residents' rooms were selected at random for inspection, and LPA Iniguez observed that the rooms were maintained in a clean and orderly manner.

On July 12, 2025, at approximately 9:00 a.m., during the records review, LPA Iniguez observed (PR#1)’s Service Agreement dated:8/23/2018. LPA Iniguez noticed that in the Service Agreement, it is written that part of the standard services provided by the facility are the following: Weekly linen laundry services and cleaning of apartments. Additionally, LPA Iniguez observed copies of the Facility Housekeeping schedule. LPA Iniguez noted that the schedule lists all residents’ rooms in the facility to be cleaned every week by the housekeeping department.

On July 12, 2025, at approximately 10:00 AM, during an Interview with the Assistant Executive Director (A#1), he stated that their housekeeping department cleans the residents’ rooms; they are under the direction of the housekeeping director. Additionally, (A#1) stated that the housekeepers clean the residents’ rooms once a week, including (PR#1)’s rooms, as included in their service agreement. In case they need more, a service fee will be included as part of their care plan. Moreover, (A#1) stated that to his knowledge, housekeepers had never failed to clean (PR#1)’s room or any other resident in care.

On July 12, 2025, at approximately 11:00 AM, LPA Iniguez was not able to spoke with (R#1) since they have passed away.

Evaluation Report continues LIC 9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 18-AS-20231222144402
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: 07/12/2025
NARRATIVE
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On July 12, 2025, at approximately 3:00 PM, LPA Iniguez was not able to connect with witness 1 (PW#1), tree attempts were made by the LPA.

On July 12, 2025, at approximately 1:00 PM, during interviews with residents (R#2-R#9), (8) out of (9) stated that they like their rooms and they are clean. Also, (8) out of (9) stated that the housekeepers clean their rooms every week.

On July 12, 2025, at approximately 11:00 AM, during interviews with facility staff (S#1-S#4), (4) out of (4) stated that the housekeeping department is the one that cleans residents' rooms every week. Also, (4) out of (4) facility staff stated that (PR#1) 's room and other residents' care rooms got cleaned as scheduled.

Allegation: Staff are not addressing pests at the facility.

The details of the complaint alleged that (R#1)’s room had pests.



On July 12, 2025, at approximately 2:00 PM, during a Health and Safety check of the facility, LPA Iniguez, along with (A#1), toured the premises. (6) residents' rooms were selected at random for inspection, and LPA Iniguez observed no signs of pests inside the residents' rooms.

On July 12, 2025, at approximately 9:00 a.m., during the records review, LPA Iniguez observed copies from copies from pest control company invoices dated: 7/2024-5-2025, LPA Iniguez noticed that the company have been coming every month since July of 2024.



On July 12, 2025, at approximately 10:00 AM, during an Interview with the Assistant Executive Director (A#1), he stated that the facility has a current contract with a pest control company that comes every month or as need it to the facility. Also, (A#1) stated that he has never seen pests in either (PR#1)’s room or any other resident in care room.
Evaluation Report continues LIC 9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 18-AS-20231222144402
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: 07/12/2025
NARRATIVE
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On July 12, 2025, at approximately 11:00 AM, LPA Iniguez was not able to spoke with (R#1) since they have passed away.

On July 12, 2025, at approximately 3:00 PM, LPA Iniguez was not able to connect with witness 1 (PW#1), tree attempts were made by the LPA.

On July 12, 2025, at approximately 1:00 PM, during interviews with residents (R#2-R#9), (8) out of (9) stated that they have not seen any pests inside their rooms.

On July 12, 2025, at approximately 11:00 AM, during interviews with facility staff (S#1-S#4), (4) out of (4) stated that they have seen the pest control company coming at the facility. Also, (4) out of (4) facility staff stated that they have not seen signs of pests inside the residents’ rooms.


During this investigation, LPA did not find sufficient evidence to support the above-mentioned allegation(s).

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.


An exit interview was conducted, and a copy of the Complaint Report was given to Nathan Boese/Assistant Executive Director.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4