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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 07/13/2025
Date Signed: 07/13/2025 12:43:36 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
06/20/2024 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240620095703
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:
07/13/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Teresa RamirezTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff are charging resident for services not rendered.
Staff are not providing residents privacy.
INVESTIGATION FINDINGS:
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On 07/13/25, Licensing Program Analyst (LPA) Elvira Gonzalez conducted a subsequent unannounced complaint visit to further investigate the allegations mentioned above and deliver findings. LPA met with Business Office Director, Teresa Ramirez, and the purpose of the visit was explained. LPA was granted entrance to the facility.

The investigation consisted of the following: On 06/24/24, the department conducted staff and resident interviews, reviewed records, obtained copies of relevant documentation, and toured the building. On 06/18/25, the department received the following documents via email: Resident Assessment for R1, Individual Service Plan for R1, Physician’s Reports for R1-R2, Identification and Emergency Information for R1-R2, Face Sheet for R1-R2, Absentee Notification for R1, Notification of Incident or Change of Condition dated: 06/19/24 and 07/01/24 for R1. On 07/12/25, the department received a staff roster, resident roster, and Resident Functional Needs Care Profile for R1-R2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2025
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 3
Control Number 18-AS-20240620095703
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: 07/13/2025
NARRATIVE
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The department conducted interviews with staff #1-#5 (S1-S5) and residents #3-#10 (R3-R10) and was unable to interview R1-R2. Furthermore, the department and Nathan Boese toured the facility and inspected rooms A202, A212, A124, A129, B101, B201 and common areas.

The investigations revealed the following:

Allegation: Staff are charging resident for services not rendered. It is being alleged that a resident is paying an additional $700.00 a month to include additional housekeeping but the service is not being provided. On 06/17/25, between 11:00 AM and 12:00 PM, the department interviewed S1-S5. Of those interviewed, 5 out of 5 staff denied the allegation. 5 out of 5 staff stated that residents are receiving the services they are paying for based on their care plan. S1 stated that all residents receive housekeeping once a week, and if additional housekeeping is needed then the residents will then pay an additional fee. S1 stated that this facility has care levels 1-6 with different rates, and staff will then follow the residents’ care plan to meet the residents needs.

On 07/12/25 between 01:30 PM and 02:35 PM, the department interviewed R3-R10. Of those interviewed, 8 out of 8 residents stated they are not being charged for services not rendered to them. 8 out of 8 residents said they are satisfied with the services provided to them.

The department conducted a review of records on 07/13/25. A Resident Functional Needs Care Profile for R1 dated: 06/21/24 revealed that R1 was receiving additional housekeeping needs. R1 was receiving assistance with making bed daily and taking trash out once per day at 10:00 AM. A Resident Functional Needs Care Profile for R2 dated: 06/21/24 revealed that R2 was receiving additional housekeeping needs. R2 was receiving assistance with making bed daily and taking trash out once per day at 08:30 AM.

Based on observation, interviews conducted, and records reviewed, there is not sufficient evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20240620095703
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: 07/13/2025
NARRATIVE
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Allegation: Staff are not providing residents with privacy. It is being alleged that staff were asked to stay in the resident’s apartment to watch over a resident. On 07/12/25, between 11:00 AM and 12:00 PM, the department interviewed S1-S5. Of those interviewed, 5 out of 5 staff said they did not know anything about the allegation. 5 out of 5 staff stated that they have not been asked to stay in a resident’s apartment to watch over a resident. S1 stated that they are not aware of staff in a resident’s apartment watching over them, but if that was to happen, it’ll only be in accordance with that resident’s care plan and the residents’ needs.

On 07/12/25 between 01:30 PM and 02:35 PM, the department interviewed R3-R10. Of those interviewed, 8 out of 8 residents stated that they are not aware if a staff member was in a resident’s apartment to watch over them. 8 out of 8 residents stated that a staff member has not been asked to stay in their apartment to watch over them. 8 out of 8 residents said they are satisfied with the services provided to them at this facility.

Based on observation, interviews conducted, and records reviewed, there is not sufficient evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

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

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2025
LIC9099 (FAS) - (06/04)
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