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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 04/24/2025
Date Signed: 04/25/2025 06:24:00 AM

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
09/10/2024 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20240910110707
FACILITY NAME:ATRIA COLLWOODFACILITY NUMBER:
374600890
ADMINISTRATOR:JULIA LOPEZFACILITY TYPE:
740
ADDRESS:5308 MONROE AVETELEPHONE:
(619) 286-3583
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:185CENSUS: 95DATE:
04/24/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Director of Culinary Services (DCS) Fernando SotoTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Staff did not provide resident records within 2 business days.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to conclude a complaint investigation. LPA was greeted by the front Receptionist Griselda Pacheco, identified herself, and met with Director of Culinary Services (DCS) Soto to whom LPA discussed the purpose of the visit.

The Department's investigation included facility and resident records reviews and resident and staff interviews.

On September 10, 2024, the Department received a complaint alleging that facility staff did not provide Resident1 (R1) their records within two days from requested as stated in regulation. An interview with Staff1 (S1) revealed that all residents and/or their Responsible Party's (RP's) receive a monthly itemized invoice. A review of facility records confirmed that itemized invoices were distributed each month.

[Continued on LIC9099C}
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 08-AS-20240910110707
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: 04/24/2025
NARRATIVE
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[Continuation of LIC9099]

The interview with S1 also disclosed that R1 had requested a cumulative itemized bill dating back to their admission with all itemized fees, to the day of their date of admission. S1 reported during the prior two months from the month the complaint was filed, they had accommodated R1’s request, which was not the standard facility procedure. S1 explained that their billing system was not set up to generate cumulative billing, it required a substantial amount of additional work, and the process was burdensome and time-consuming.

A review of facility records, Licensing regulations, and Health and Safety (H&S) code revealed that residents have the right to their records within two days from requesting them, however this included records maintained on file by the facility, and required records per mandate. The records reviews showed that only itemized monthly billing are required, and there were no cumulative bills for residents in care covering the time from admission generated and/or maintained on file.

Based on interviews and records reviews, the above allegation was determined to be Unsubstantiated. An Unsubstantiated finding means the standard of evidence was not met to prove there was a violation.

An exit interview was conducted with DCS Soto, and a copy of this report and Licensee Appeal Rights (LIC 9058) were left for facility records.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2