347000389-3-14-2024-59-AS-KHOS-D3GJEM-20240318065923

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 347000389
Report Date: 03/14/2024
Date Signed: 03/14/2024 12:51:11 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/03/2023 and conducted by Evaluator Cassie Yang

COMPLAINT CONTROL NUMBER: 59-AS-20230703092623

FACILITY NAME:	ATRIA EL CAMINO GARDENS		FACILITY NUMBER:	347000389
ADMINISTRATOR:	KIMBERLY HAGEN		FACILITY TYPE:	740
ADDRESS:	2426 GARFIELD AVE		TELEPHONE:	(916) 488-5722
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	325	CENSUS: 189	DATE:	03/14/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Natasha Georges		TIME COMPLETED:	09:55 AM

ALLEGATION(S):

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Facility is not allowing resident to leave the facility.

INVESTIGATION FINDINGS:

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On 3/14/2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to deliver the finding regarding the allegation the department received. LPA met with Executive Director, Natasha Georges, and explained the purpose of the visit.

During the investigation, LPA conducted extensive interviews.

Result of the investigation is as follow.

Please continue on LIC 9099-C...

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie Yang	TELEPHONE: (916) 201-1928
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

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 59-AS-20230703092623

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ATRIA EL CAMINO GARDENS	FACILITY NUMBER: 347000389
	VISIT DATE: 03/14/2024

NARRATIVE

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LIC 9099-C...

Allegation: Facility is not allowing resident to leave the facility.

The Department conducted extensive interviews regarding the allegation of the complaint. Interview conducted with R1 revealed that R1 was stopped by Executive Director who did not allow R1 to leave the premises. Interview conducted with Executive Director revealed that Executive Director had stopped R1 and asked R1 to sign out prior to leaving the facility. Interview further revealed this best practice protocol is conducted on all residents to ensure their safe returning. Executive Director stated R1 became upset and Executive Director contacted the corporate office for further assistance and was advised to not continue enforcing R1 to sign out. Interview revealed R1 chose to not leave the premises after this incident as Executive Director informed R1 it is fine, he can leave but observed R1 entering back to the facility into the common areas. Interview conducted with Assistant Executive Director revealed that R1 was upset and did not want to cooperate with facility staff when asked to sign out. Interview conducted with R2 revealed that R2 does not have an issue leaving the facility. R2 stated that she and/or family member comply with the sign out protocol with no issue.

Based on information obtained, LPA finds the allegation to be UNFOUNDED-means that the allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted, and a copy of the report and appeal rights was provided via email.

SUPERVISOR'S NAME: Anthony Perez	TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie Yang	TELEPHONE: (916) 201-1928
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2024

LIC9099 (FAS) - (06/04)

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