405850034-3-22-2023-29-AS-KBUY-CR9NJQ-20230426103042

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 03/22/2023
Date Signed: 03/22/2023 03:36:50 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/20/2022 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20220720160706

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: 51	DATE:	03/22/2023
		UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Karen Enciso, Interim Executive Director		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff disclosed resident's confidential information in the presence of others.

INVESTIGATION FINDINGS:

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On 3/22/23 at 1:35 pm, Licensing Program Analyst (LPA) Darlene Chavez conducted an unannounced follow-up visit to deliver final findings on the original complaint dated 7/20/22. LPA met with Karen Enciso, Interim Executive Director/Administrator, and explained the purpose of the visit.

On the allegation, “Staff disclosed resident's confidential information in the presence of others,” the complainant’s concern was that staff were discussing confidential information over their walkie-talkies, which could have been overheard by others. Resident interviewed stated that a staff was assisting them with medications in their room with the door open. The resident had a question about their medications and the staff radioed to another Med Tech on the walkie-talkie. The resident stated that other people could have overheard the conversation, either outside the door or in the area the other Med Tech was in.

Continued on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

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 29-AS-20220720160706

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 03/22/2023

NARRATIVE

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The resident stated they were not certain anyone overheard, but was concerned that it could have happened. Multiple Med Techs interviewed by LPA indicated they use the room numbers of residents instead of names when speaking over the walkie-talkies to help protect resident privacy. Administrator stated she has previously discussed in meetings to be careful about what information staff discuss if persons are around, both in the Wellness Office and over the walkie-talkie, to ensure resident privacy. Based on the information obtained, the allegation is deemed Unsubstantiated at this time. LPA recommends that Administrator continue to discuss policies that ensure resident privacy.

Exit interview conducted and report given to the Interim Executive Director.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023

LIC9099 (FAS) - (06/04)

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