374600890-3-5-2024-08-AS-SJAB-D3PTML-20240325145119

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 03/05/2024
Date Signed: 03/05/2024 01:06:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 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
02/26/2024 and conducted by Evaluator Tiffany Holmes

COMPLAINT CONTROL NUMBER: 08-AS-20240226111527

FACILITY NAME:	ATRIA COLLWOOD		FACILITY NUMBER:	374600890
ADMINISTRATOR:	JULIA LOPEZ		FACILITY TYPE:	740
ADDRESS:	5308 MONROE AVE		TELEPHONE:	(619) 286-3583
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	185	CENSUS: 82	DATE:	03/05/2024
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Patricia "Kitty" Totorica, Business Director		TIME COMPLETED:	01:12 PM

ALLEGATION(S):

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Staff are not properly cleaning resident's restroom
Staff are not properly addressing pest infestation in facility
Staff did not assist resident in a timely manner
Staff did not ensure to empty resident’s trash can

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tiffany Holmes conducted an unannounced visit regarding the above mentioned allegations. LPA stated the purpose of the visit, was granted entry by and met with Patricia "Kitty" Totorica, Business Director.

LPA briefly toured the facility, and obtained copies of pertinent facility records. LPA conducted interviews with staff and residents. It was alleged that the staff are not properly cleaning resident's restroom. Interviews revealed that Resident 1 (R1) gets their room cleaned weekly. This consists of the shower being cleaned, floors are being swept and mopped, and the sink is being cleaned. The bed sheets are usually changed once a week but for R1 they are usually changed every two weeks unless otherwise noted. The housekeeper also empties the trash and vacuums the room.
Interviews did not provide supporting information that staff are not properly cleaning resident's restroom.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

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 08-AS-20240226111527

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ATRIA COLLWOOD	FACILITY NUMBER: 374600890
	VISIT DATE: 03/05/2024

NARRATIVE

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It was alleged that staff are not properly addressing pest infestation in the facility. Interviews revealed that they have not seen any ants or silverfish in R1's room or around the facility. Interviews with R1 revealed they saw two ants yesterday, 03/04/2024 and no ants today. LPA observation did not reveal ants on the dresser or on the trash can as R1 stated. There were no dead ants or any trace of ants or silverfish in the bedroom or the bathroom. Interview with R1 also revealed that they believe that if the housekeeper saw the silverfish they would have picked it up. "It was an accident that they missed it". Interviews did not provide supporting information that staff are not properly addressing pest infestation in the facility.

It was alleged that the staff did not assist resident in a timely manner. Interviews revealed that the staff assists all residents in a timely manner. Interviews revealed R1 demands that the staff help them right at that moment. Interviews revealed that when the request is made, it will be completed by staff. Interviews revealed all of R1 needs are met and they will ask for assistance and the staff assist them. R1 made a complaint about the ants to the maintenance director about 3 weeks ago and they came right in and put ant bait around the room. Interviews revealed all requests are not of immediate action although R1 treats all request as an emergency. Interviews with other residents revealed the staff are kind and assist them with their needs and they do not have to wait a long time to be helped. There were no complaints of the staff not assisting residents or not being timely. Interviews did not provide supporting information that staff did not assist resident in a timely manner.

It was alleged that the staff did not ensure to empty resident’s trash can. Interviews revealed the trash is emptied everyday. Interviews with R1 revealed their trash is emptied daily but sometimes its in the middle of the afternoon. Interviews revealed staff are usually doing their rounds in the am and into the afternoon. Interviews with staff revealed they all have been notified not to knock or go into R1's room until after 10am. Interviews revealed all trash is picked up daily and if a resident request that their trash be emptied again the staff have no problem emptying it again. Interviews did not provide supporting information that staff did not ensure to empty resident’s trash can.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

LIC9099 (FAS) - (06/04)

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Control Number 08-AS-20240226111527

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ATRIA COLLWOOD	FACILITY NUMBER: 374600890
	VISIT DATE: 03/05/2024

NARRATIVE

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Based upon the evidence gathered during this investigation, insufficient information was obtained to support the allegations of staff are not properly cleaning resident's restroom,
staff are not properly addressing pest infestation in facility, staff did not assist resident in a timely manner and staff did not ensure to empty resident’s trash can. The Preponderance of Evidence Standard was not met. As such, the allegations are Unsubstantiated.

An exit interview was conducted with Patricia "Kitty" Totorica, Business Director. and a copy of the report and the Licensee/Appeal Rights (LIC 9058 03/22) were provided to Director, whose signature confirms receipt of receiving the documents.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 301-9770
LICENSING EVALUATOR NAME: Tiffany Holmes	TELEPHONE: (619) 481-0843
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

LIC9099 (FAS) - (06/04)

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