<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374604177
Report Date: 05/16/2023
Date Signed: 05/16/2023 07:56:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 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
05/11/2020 and conducted by Evaluator Nacole Patterson
PUBLIC
COMPLAINT CONTROL NUMBER: 08-AS-20200511081450
FACILITY NAME:ATRIA BONITAFACILITY NUMBER:
374604177
ADMINISTRATOR:WILLIAMS, REBECCAFACILITY TYPE:
740
ADDRESS:3434 BONITA ROADTELEPHONE:
(619) 476-9444
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:0CENSUS: 0DATE:
05/16/2023
UNANNOUNCEDTIME BEGAN:
07:35 PM
MET WITH:Facility Closed- Report Mailed to Address on FileTIME COMPLETED:
07:36 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff refused to pick up resident from hospital
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
The following determination of findings has been made by Licensing Program Analyst (LPA) Nacole Patterson regarding the above allegation. The facility closed on January 20th, 2023, due to a change of ownership, and this report was mailed to the last known address on record for the former licensee regarding the findings.

On 5/11/2020 it was alleged that facility staff refused to pick up a resident from the hospital. The Department’s investigation consisted of review of facility records, and interviews with facility staff and outside sources.

Staff interviews revealed that the facility and hospital were not in agreement with the level of transferring assistance required for the resident, however, the resident was admitted back to the facility after hospital discharge. Outside source interview revealed that the resident was discharged from the hospital and returned back to the facility on 5/11/2020 and confirmed that the facility and hospital were in disagreement regarding if the resident was a two or one-person assist. (Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023
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 2
Control Number 08-AS-20200511081450
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME: ATRIA BONITA
FACILITY NUMBER: 374604177
VISIT DATE: 05/16/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Continued from LIC9099

Records review revealed that the resident was admitted to the facility on 5/10/2020 and returned back to the facility on 5/11/2020. Records review found that that the facility was anticipating issuing a 30-day notice due to the resident’s increased needs and behaviors, and the fact that the private pay caregiver refused to provide full care due to Covid-19 concerns. Records review found that the hospital declined to admit the resident into the skilled nursing unit upon Executive Director request and the resident was instead returned back to the facility, after which the facility initiated a 30-day eviction protocol for the resident.

Based on interviews, direct LPA observations and records review, a preponderance of evidence does not exist to prove that the alleged violation occurred, therefore the allegation is UNSUBSTANTIATED. A copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were mailed to the last known address on file.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) 767-2351
LICENSING EVALUATOR NAME: Nacole PattersonTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2