336400075-7-25-2024-18-AS-RORN-DGAL5S-20250502082733

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 07/25/2024
Date Signed: 07/25/2024 12:32:08 PM

Unfounded

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
07/17/2024 and conducted by Evaluator Janette Romero

COMPLAINT CONTROL NUMBER: 18-AS-20240717101852

FACILITY NAME:	ATRIA HACIENDA		FACILITY NUMBER:	336400075
ADMINISTRATOR:	ROBERT STANSBURY		FACILITY TYPE:	740
ADDRESS:	44600 MONTEREY AVE		TELEPHONE:	(760) 341-0890
CITY:	PALM DESERT	STATE: CA	ZIP CODE:	92260
CAPACITY:	266	CENSUS: 163	DATE:	07/25/2024
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Administrator, Monique Moreira		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are denying authorized representative access to the facility

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 7/25/2024, Licensing Program Analyst (LPA), Janette Romero arrived unannounced to investigate into the allegation listed above. LPA met with Administrator, Monique Moreira who was informed of the purpose of the visit.

It was alleged the facility did not allow Resident 1 (R1) and Resident 2’s (R2’s) Power of Attorney (POA) agent on the property. LPA conducted a record review of R1 and R2’s file and did not observe a POA form. R1 and R2’s admission agreement dated 9/21/2022 identifies a responsible person; however, their Identification and Emergency Information (LIC 601) dated 4/21/2022 notes both residents are self-responsible. LPA interviewed Administrator, Monique Moreira who reported on 6/20/2024, R1 and R2’s family became hostile with her over a billing dispute. Administrator Moreira reported R1 and R2’s family were inside her office and in the lobby yelling at her in the presence of other residents and staff.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

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-20240717101852

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: 07/25/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Administrator Moreira added R1 and R2’s family were kindly asked to step outside. Administrator Moreira reported law enforcement was called and issued Trespass Arrest Authorizations for three (3) of R1 and R2’s family members, including R1 and R2’s responsible person. LPA contacted law enforcement and verified the three (3) Trespass Arrest Authorizations are valid. LPA made several attempts to contact the reporting party and did not receive a response. R1 and R2 have since been relocated and were unable to be located for an interview.

LPA interviewed one (1) resident who was identified as a possible witness. The resident corroborated witnessing R1 and R2’s family yelling profanities and behaving hostile towards Administrator Moreira and others around them. The resident reported they also asked R1 and R2's family to step outside to calm down and was yelled at by them.

Based on the aforementioned, this agency has investigated the complaint alleging, “Staff are denying authorized representative access to the facility”. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. An exit interview was conducted, and a copy of this report was provided Administrator Moreira.

SUPERVISOR'S NAME: Tricia Danielson	TELEPHONE: (951) 202-5067
LICENSING EVALUATOR NAME: Janette Romero	TELEPHONE: (951) 529-2930
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2