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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336400954
Report Date: 10/29/2024
Date Signed: 10/29/2024 04:09:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/27/2023 and conducted by Evaluator Yolanda Delgado
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20230127151107
FACILITY NAME:ATRIA PALM DESERTFACILITY NUMBER:
336400954
ADMINISTRATOR:FLORES, DENISEFACILITY TYPE:
740
ADDRESS:44300 SAN PASCUAL AVETELEPHONE:
(760) 773-3772
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:154CENSUS: 74DATE:
10/29/2024
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Cheree Escandel, AdministratorTIME COMPLETED:
04:08 PM
ALLEGATION(S):
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Staff did not provide resident records to resident and/or resident's legal representative
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Yolanda Delgado arrived unannounced to the facility to conclude an investigation into the allegation listed above. LPA met with Cheree Escandel, Administrator and explained the purpose of the visit.

On January 27, 2023, Community Care Licensing received a complaint alleging that staff did not provide resident records to resident and /or resident’s legal representative. LPA conducted interviews with Administrator, staff, and additional witnesses. LPA also conducted a review of pertinent documentation. LPA was unable to interview Resident #1 (R1) in order to obtain pertinent information due to R1 passing away on September 21, 2022.

It was alleged that resident’s legal representative sent a request for resident records to the facility on January 17, 2023. It was reported that records were not sent to the resident’s representative until February 3, 2023. Information obtained from Administrator indicate that request for records were sent on February 2, 2023.
(Continued on Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
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 3
Control Number 18-AS-20230127151107
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PALM DESERT
FACILITY NUMBER: 336400954
VISIT DATE: 10/29/2024
NARRATIVE
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(Continued from Page 2)

LPA observed documentation that corroborated the documents were sent on February 3, 2023. Title 22 regulations state that (a) In addition to the rights listed in Section 87468.1 Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights: (2) To have their records and personal information remain confidential and to approve their release, except as authorized by law.

Therefore, based on observations and interviews, the allegation that Staff did not provide resident records to resident and/or resident’s legal representative is SUBSTANTIATED. The facility will be cited for Title 22, Division 6, Chapter 8, Article 08, Section 87468.2 (a)(2).

An exit interview was conducted where this report, 9099-D, and appeal rights were discussed. Copies of the documents were provided to Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 18-AS-20230127151107
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 PALM DESERT
FACILITY NUMBER: 336400954
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/12/2024
Section Cited
CCR
97868.2(a)(2)
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Additional Personal Rights in Privately Operated Facilities...(a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:
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Licensee will abide by Title 22 and deliver douments within the appropriate deadline given.
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(2) To have their records and personal information remain confidential and to approve their release, except as authorized by law. This requirement was not being met as evidenced by: LPA review records request for records was sent on 1/17/2023 to the facility and facility sent records on 2/3/2023 to the legal representative. This poses a potential health and safety risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Yolanda Delgado
LICENSING EVALUATOR SIGNATURE:

DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3