374600890-5-12-2023-08-AS-SJAB-CSCRXL-20230531132456

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 05/12/2023
Date Signed: 05/12/2023 03:11:41 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2023 and conducted by Evaluator Iby Strong

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20230508153605

FACILITY NAME:	ATRIA COLLWOOD		FACILITY NUMBER:	374600890
ADMINISTRATOR:	ARTEAGA, IRMA		FACILITY TYPE:	740
ADDRESS:	5308 MONROE AVE		TELEPHONE:	(619) 286-3583
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	185	CENSUS: 84	DATE:	05/12/2023
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Executive Director Julia Lopez		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Iby Strong conducted an unannounced visit to initiate a complaint investigation. LPA identified herself and discussed the basic elements of the complaint with Executive Director (ED) Julia Lopez.

On May 8, 2023, Community Care Licensing (CCL) received a complaint alleging facility is in disrepair. It was reported to CCL that Resident 1’s (R1) heating, ventilation, and air conditioning (HVAC) system was not working and at times being too hot or too cold. During investigation, LPA Strong collected pertinent resident records as well as facility documentation and conducted interviews. According to interviews with staff, facility heating, and cooling systems are independent room to room. Interview with Maintenance Director revealed that when HVAC systems are not working a work-order is created and followed up with. Records collected revealed there were two work orders for HVAC in question, one on February 24, 2023, and another on March 31, 2023.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

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 08-AS-20230508153605

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ATRIA COLLWOOD	FACILITY NUMBER: 374600890
	VISIT DATE: 05/12/2023

NARRATIVE

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Staff interviews revealed that the system in question is either a heater or a cooling system. Interview with R1 revealed facility staff have adjusted the unit multiple times. On today’s day, LPA Strong observed the unit in question which shows temperature at 80 degrees Fahrenheit, LPA laser thermostat demonstrated temperature reading of 81.1 degrees Fahrenheit in all corners of the room. Interview with resident revealed that unit’s digital reading is missing a dash above the first digit, making it difficult for resident to correctly read temperature. Interview also revealed that resident prefers room between 80-83 degrees Fahrenheit.

Based on LPA's observations, record reviews and interviews there is not a preponderance of evidence to prove alleged violation occurred, therefore the allegation is unsubstantiated. An exit interview was conducted with Executive Director (ED) Julia Lopez, to whom a copy of this report, and the Licensee/Appeal Rights (LIC 9058 03/22) were provided.

SUPERVISOR'S NAME: John Rante	TELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Iby Strong	TELEPHONE: 619-481-0846
LICENSING EVALUATOR SIGNATURE:	DATE: 05/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023

LIC9099 (FAS) - (06/04)

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