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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347000389
Report Date: 06/30/2020
Date Signed: 06/30/2020 11:49:21 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/30/2020 and conducted by Evaluator Melana Llopis
PUBLIC
COMPLAINT CONTROL NUMBER: 27-AS-20200330164847
FACILITY NAME:ATRIA EL CAMINO GARDENSFACILITY NUMBER:
347000389
ADMINISTRATOR:SLOAN, ASHLEEFACILITY TYPE:
740
ADDRESS:2426 GARFIELD AVETELEPHONE:
(916) 488-5722
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:325CENSUS: 223DATE:
06/30/2020
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Deborah Ahrens, Senior Community Business DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff are not cleaning the residents room properly
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Llopis contacted the facility via telephone due to COVID-19 and pre-cautionary measures on 06/30/2020 to deliver findings for a complaint the Department received on 03/30/2020. LPA spoke with Senior Community Business Director, Deborah Ahrens and explained the purpose of the call.

Throughout the course of the investigaiton, the Department conducted multiple interviews and reviewed documentation pertinent to the allegation listed above.


***Continuation on 9099-C***

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 214-0485
LICENSING EVALUATOR NAME: Melana LlopisTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2020
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 27-AS-20200330164847
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: ATRIA EL CAMINO GARDENS
FACILITY NUMBER: 347000389
VISIT DATE: 06/30/2020
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The results are as follows:

Allegation: Staff are not cleaning the residents room properly

The investigation determined Resident (R1) was admitted into the facility on 11/11/2013 with a private room. Upon admission, R1 signed an admission agreement that states the facility agrees to “provide weekly linen laundry service and apartment cleaning.” Since R1’s admittance, R1’s family member would provide additional housekeeping, however, due to COVID-19 and pre-cautionary measures, the facility limited access to only health care providers. Key witnesses stated they observed R1’s room to not be cleaned properly by the facility, however no further evidence was made available for review. The Department interviewed five (5) randomly selected residents who stated the facility does a “good job” with cleaning their rooms and laundry. R1 was unreliable for statements due to medical assessment. The Department conducted a virtual tour of the facility and resident rooms, and found the facility to be clean and in good repair.

Due to the above information the Department finds the allegation to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

As a result of this investigation, no deficiencies were cited, per Title 22 Regulations, Division 6.

Exit interview conducted via telephone due to COVID-19 and pre-cautionary measures. A copy of this report will be sent to facility. The Department is requesting the facility to send a signed copy of the report back to CCL.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 214-0485
LICENSING EVALUATOR NAME: Melana LlopisTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2020
LIC9099 (FAS) - (06/04)
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