405850034-8-30-2022-29-AS-DCHZ-CHSU26-20220830151125

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 405850034
Report Date: 08/30/2022
Date Signed: 08/30/2022 03:12:07 PM

Document Has Been Signed on 08/30/2022 03:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	KARI BOWRON		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 541-4222
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS: 57	DATE:	08/30/2022
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Karen Enciso, Interim Administrator		TIME COMPLETED:	01:33 PM

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	An Informal Conference was conducted today via Teams. The purpose of the Informal Conference was to discuss the multiple complaints received and deficiencies cited for Avila Senior Living at Downtown SLO. Present at today’s meeting were: Kelly Burley, Licensing Program Manager (LPM); Darlene Chavez, Licensing Program Analyst (LPA); Pacifica Senior Living: Carl Knepler, Senior Vice President of Operations; Rob Henderson, Senior Vice President of Operations; Marlene Nelson, Director of Compliance; Cassondra Bradford, Vice President of Operations; Karen Enciso, Continuous Improvement Specialist/Nurse; Paulette Rubiales, Corporate Compliance/Nurse. The Informal Conference process was explained. The Pacifica Senior Living team was notified that this Informal Conference is a part of the Administrative Action process and that further citations may result in Probation or a formal Non-Compliance Plan, which could then lead to a referral to the Department's Legal Division for possible Administrative Action. Continued on 809-C.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: AVILA SENIOR LIVING AT DOWNTOWN SLO	FACILITY NUMBER: 405850034
	VISIT DATE: 08/30/2022

NARRATIVE

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Today's conference addressed the following issues:

· The facility has received 20 complaints since licensure in February 2020.
· Multiple administrators and interim administrators since licensure
· Staff caused injury to resident in care
· Insufficient staffing
· Lack of safe environment
· Medication issues
· Food services issues
· Fingerprint clearance issues
· Illegal rate increases
· Unlawful eviction
· Transportation issues, including to medical appointments
· COVID-19 protocols including mask wearing
· Physical plant issues

LPM noted some of the issues had been cited multiple times, and expressed the importance of having a certified administrator for the facility. Pacifica Senior Living acknowledged that the facility has issues, they have brought on additional support staff, and stated they are committed to working on the issues. Mr. Henderson announced that a new Executive Director would be in place soon.

Exit interview. Report emailed for signature.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC809 (FAS) - (06/04)

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