374604177-3-6-2023-08-AS-SJAB-CPRUEZ-20230309143154

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374604177
Report Date: 03/06/2023
Date Signed: 03/06/2023 05:07:23 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
03/28/2022 and conducted by Evaluator Esther Miller

PUBLIC

COMPLAINT CONTROL NUMBER: 08-AS-20220328130900

FACILITY NAME:	ATRIA BONITA		FACILITY NUMBER:	374604177
ADMINISTRATOR:	JULIA LOPEZ		FACILITY TYPE:	740
ADDRESS:	3434 BONITA ROAD		TELEPHONE:	(619) 476-9444
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91910
CAPACITY:	0	CENSUS: 0	DATE:	03/06/2023
		UNANNOUNCED	TIME BEGAN:	04:27 PM
MET WITH:	Facility closed - Mailed to address on file		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility did not meet resident's toileting needs.
Facility did not provide medication according to the physician's directions.
Facility did not meet resident's dietary needs.
Licensee did not employ staff in numbers necessary to meet residents’ needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Esther Miller made a determination of findings and concluded the complaint investigation regarding the above allegations. The facility closed on January 20, 2023 due to a change of ownership, and this report was mailed to the address on record of the former licensee in order to share the findings.

On March 28, 2022, it was alleged that licensee did not employ staff in numbers necessary to meet resident needs, specifically resulting in facility not meeting residents’ toileting needs, not providing medication according to physician's directions, and not meeting residents’ dietary needs. The Department’s investigation consisted of review of limited facility records and interviews of facility staff, residents, and outside sources. A separate case management report was created to address the limited number of documents provided by facility to assist with the investigation.

[Continued on LIC9099-C, Page 1 of 3]

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Esther Miller	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

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 3

Control Number 08-AS-20220328130900

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 BONITA	FACILITY NUMBER: 374604177
	VISIT DATE: 03/06/2023

NARRATIVE

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[Continued from LIC9099, Page 2 of 3]

Facility records showed that on March 14, 2022, facility employed thirty (30) caregivers and med techs, and eight (8) servers. On that date, the facility had eighty-seven (87) assisted living residents and sixteen (16) memory care residents. Of the assisted living residents, forty-three (43) were not charged for additional services (independent). Of the assisted living resident, twenty (20) were paying less than $1000 a month in additional services. Facility did not produce a staff schedule for the month of March 2022.

On April 4, 2022, facility employed thirty-two (32) caregivers and med techs, and seven (7) servers. On that date, the facility had eighty-six (86) assisted living residents and seventeen (17) memory care residents. Of the assisted living residents, forty-two (42) were not charged for additional services (independent). Of the assisted living resident, twenty-two (22) were paying less than $1000 a month in additional services. Facility did not produce a staff schedule for the month of April 2022.

Facility also did not produce a fee schedule for each level of care during March or April 2022. However, a partial Admissions Agreement from 2020 showed Appendix B of the Admissions Agreement was titled "Levels of Care Descriptions and Fees". Document showed that there were five (5) levels of care depending on additional hours of care needed: Level 1, $600; Level 2, $1200; Level 3, $1800; Level 4, $2200; Level 5, $2500. There were no additional care fees for memory care. Residents care level was decided prior to move-in through an assessment. Therefore, on March 14, 2022, at least twenty-four (24) assisted living residents and seventeen (17) memory care residents required a higher level of care. On April 4, 2022, at least twenty-two (22) assisted living residents and seventeen (17) memory care residents required a higher level of care. Resident and staff interviews indicated that, although there may have been one (1) or two (2) caregivers per shift, resident needs, including toileting, were met by reassigning med techs and administrative staff to assist in direct care. The allegations that facility did not meet residents’ toileting needs and that licensee did not employ staff in numbers necessary to meet resident needs are found to be UNSUBSTANTIATED.

It was further alleged that facility did not provide medication according to the physician's directions. Interviews with residents indicated that there were no known incidents of medication mishandling, nor any

[Continued on LIC9099-C, Page 2 of 3]

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Esther Miller	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 08-AS-20220328130900

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 BONITA	FACILITY NUMBER: 374604177
	VISIT DATE: 03/06/2023

NARRATIVE

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[[Continued from LIC9099-C, Page 3 of 3]

known incidents where medication was not given on time. Staff interviewed denied the allegation. A random selection of Medication Administration Records (MAR) showed that medication was properly logged, signed, and given as prescribed by staff. Any missed medication was noted by staff with the reason (such as “Refused”). Therefore, the allegation that facility did not provide medication according to the physician's directions is found to be UNSUBSTANTIATED.

It was further alleged that facility did not meet residents’ dietary needs. Interview with Dining Service Director (DSD) on February 7, 2023 explained that resident’s with dietary needs were sent to them via email by the Resident Service Coordinator. LPA observed list was kept in an area visible to staff and not to residents. DSD also showed an example menu in which alternative meals were offered to meet residents’ dietary needs. Interviews with former DSDs employed during March and April 2022 could not be obtained. A list of residents with special diet needs in March and April 2022 was not provided by the facility. Instead, facility provided a list of residents who had special diets in December 2022. Interviews with residents indicated that their dietary needs were met. Therefore, the allegation that facility did not meet residents’ dietary needs is found to be UNSUBSTANTIATED.

Based on the evidence obtained during the complaint investigation, all allegations are found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or may be valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. A copy of this report and Licensee's Rights (LIC9058) were mailed to last known address on file.

SUPERVISOR'S NAME: Denise Powell	TELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Esther Miller	TELEPHONE: 619-767-2301
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

LIC9099 (FAS) - (06/04)

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