347000389-10-27-2021-25-AS-MSEY-C8DKVX-20211102081502

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347000389
Report Date: 10/27/2021
Date Signed: 10/27/2021 03:44:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/09/2021 and conducted by Evaluator Angela Hood

COMPLAINT CONTROL NUMBER: 25-AS-20210909134608

FACILITY NAME:	ATRIA EL CAMINO GARDENS		FACILITY NUMBER:	347000389
ADMINISTRATOR:	RIST, ALICIA		FACILITY TYPE:	740
ADDRESS:	2426 GARFIELD AVE		TELEPHONE:	(916) 488-5722
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	325	CENSUS: 205	DATE:	10/27/2021
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Kimberly Hagen, Senior Executive Director		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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-Unlawful eviction

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Angela Hood and Michael Hood arrived at the care home today and met with the Senior Executive Director, Kimberly Hagen, to deliver findings into the allegation of unlawful eviction. LPAs wore N95 masks and were screened upon entry in the care home. All staff wore masks in the care home. There are no COVID positive cases at the facility.

Unlawful eviction:
On 9/3/21, the facility issued, via certified mail, a 30-day notice to terminate resident (R1) and also mailed a copy to R1’s responsible person. The notice indicates termination of R1’s residency beginning 10/4/21 due to R1 failing to comply with the general policies of the community. R1 and their responsible person signed the facility’s Admission Agreement on 1/26/21. The Admission Agreement’s sections pertaining to their Motorized Cart Policy and their House Rules indicate that residents shall operate their motorized carts in a “safe manner, taking special precautions near doorways, at corners, when approaching pedestrians, backing up, and in other situations that present an additional risk of injury”.

************************************************Continued on LIC9099-C**************************************************

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 214-0485
LICENSING EVALUATOR NAME: Angela Hood	TELEPHONE: 650-676-0390
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 25-AS-20210909134608

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: ATRIA EL CAMINO GARDENS	FACILITY NUMBER: 347000389
	VISIT DATE: 10/27/2021

NARRATIVE

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According to interviews with staff (S1, S2, and S3), R1 has had several occasions of not operating their motorized scooter in accordance with the facility’s policy. The facility provided LPA with a written statement from S2 for an incident on 8/25/21 were R1 was operating their motorized cart at a fast speed, which is also indicated in the 30-day notice to terminate sent to R1.

Interviews with S1 and S3 indicated that, on 9/1/21, R1 was intoxicated and not operating their motorized scooter in a safe manner. Interview with S1 indicated that R1 was operating their scooter at a high speed and almost hit S1. Interview with S3 indicated that R1 was operating their scooter at a high speed almost hitting another resident and ended up running into a bench. Both S1 and S3 stated that they had a conversation with R1 regarding their motorized scooter speed. A written statement from staff (S4) indicates that, on 9/1/21, R1 was intoxicated and operating their motorized cart in an unsafe manner, running into the walls and almost running into another resident.

Notes provided by the facility indicate that conversations were made with R1 and/or responsible person on 8/26/21 and 9/1/21. The House Rules in the Admission Agreement indicate that “residents may choose to drink alcoholic beverages in their apartments provided that their conduct does not disturb other residents or pose a health and safety risk to themselves or others”.

Title 22, Division 6, Chapter 8, Section 87224(a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). (3) Failure of the resident to comply with general policies of the facility. Said general policies must be in writing, must be for the purpose of making it possible for residents to live together and must be made part of the admission agreement.

Based on records reviewed and interviews conducted, the above allegation is found to be UNFOUNDED. A finding that the allegation is unfounded means that the allegation is false, could not have happened, and/or is without a reasonable basis. Exit interview conducted.

SUPERVISOR'S NAME: Maribeth Senty	TELEPHONE: (916) 214-0485
LICENSING EVALUATOR NAME: Angela Hood	TELEPHONE: 650-676-0390
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2021

LIC9099 (FAS) - (06/04)

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