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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347000389
Report Date: 08/06/2021
Date Signed: 08/06/2021 04:35:35 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
08/05/2021 and conducted by Evaluator Melana Llopis
COMPLAINT CONTROL NUMBER: 25-AS-20210805163237
FACILITY NAME:ATRIA EL CAMINO GARDENSFACILITY NUMBER:
347000389
ADMINISTRATOR:RIST, ALICIAFACILITY TYPE:
740
ADDRESS:2426 GARFIELD AVETELEPHONE:
(916) 488-5722
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:325CENSUS: 224DATE:
08/06/2021
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Administrator, Alicia RistTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Residents were not treated with dignity and respect. Employee showered residents in cold water and verbally abused residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Melana Llopis arrived at the facility unannounced on 08/06/2021 to open a complaint the Department received on 08/05/2021. Prior to visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; upon entry completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical mask. Additionally, LPA was screened by staff, Vanessa Jones, upon entering the facility.
LPA met with Business Director (BD), Deborah Ahrens and Administrator (AD), Alicia Rist.
LPA requested the following documentation for review: documentation of the investigation and termination of staff, Carmencita Phelps (S1). LPA interviewed BD, AD and Life Guidance Director, Ingrid Weber.
BD, AD and LG stated the abuse did occur and S1 admitted to abusing residents (R1, R2, and R3) by giving them cold showers and verbally threatening the residents.
A deficiency is being cited due to the information stated above on LIC9099-D, per California code of regulation, title 22.
Exit interview conducted, copy of report and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melana LlopisTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
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-20210805163237
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2021
Section Cited
CCR
87468.1(a)(3)
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87468.1 Personal Rights of Residents in All Facilities
(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:
(3) To be free from punishment, humiliation, intimidation, abuse...
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Licensee terminated staff (S1) on 8/4/2021 as a corrective action.
Licensee stated they held an in-service training on elder abuse for all employees. Licensee agrees to provide documentation of all the staff in attendance for the in-service training conducted on 08/05/2021 by POC date.
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This requirement was not met as evidenced by:
S1 admitted to giving residents (R1, R2, and R3) cold showers and verbally threatening residents in care. This posed an immediate health, safety and personal rights risk to residents in care.
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Documenation includes all employees' signatures who were in attendance.
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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.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melana LlopisTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC9099 (FAS) - (06/04)
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