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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347000389
Report Date: 08/19/2021
Date Signed: 08/19/2021 02:51:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 GARDENSFACILITY NUMBER:
347000389
ADMINISTRATOR:RIST, ALICIAFACILITY TYPE:
740
ADDRESS:2426 GARFIELD AVETELEPHONE:
(916) 488-5722
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:325CENSUS: 220DATE:
08/19/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator, Alicia RistTIME COMPLETED:
03:00 PM
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Licensing Program Analysts (LPAs) Melana Llopis and Sabrina Calzada arrived at the facility unannounced on 08/19/2021 to conduct a case management inspection to ensure the facility is in compliance with Health and Safety Code 1569.38 Posting of licensing reports; disclosure to new residents following the department serving an Accusation on 08/03/2021. LPAs met with Administrator, Alicia Rist and explained the purpose of the visit.
Prior to visit, LPAs 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. LPAs ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Masks. Additionally, LPAs were screened by Mackenzie Stroud, staff, upon entering the facility.

Administrator showed LPAs the posted notice dated 8/13/2021 displayed in the hallway next to the nearest entryway. LPAs observed the posted notice to contain the required elements. Administrator will adjust the current contact name and number for the person designated by the Community Care Licensing Division of the department to Licensing Program Manager, Maribeth Senty. Administrator made the adjustment prior to exit interview. Administrator stated that all (220) residents/resident representatives were informed via written notice. LPAs observed a signed copy of the notice given to each resident/resident representative.

LPA and Administrator confirmed with (1) resident's receipt of a letter from the facility regarding the pending legal matter. LPAs confirmed with resident, R1 that a notice was received recently, within the last week, regarding a licensing matter.

There are no deficiencies being cited today.
Exit interview conducted and copy of report provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melana LlopisTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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