405850034-10-26-2023-29-AS-KBUY-CY33CT-20231129170829

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 10/26/2023
Date Signed: 10/26/2023 11:21:23 AM

Substantiated

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
10/16/2023 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20231016081953

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	DARLENE MARKHAM		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 541-4222
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS:	DATE:	10/26/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility did not provide safe, healthful accommodations for residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon conducted a subsequent complaint visit to the facility above to deliver final findings of the complaint allegation. LPA met with Administrator Darlene Markham and explained the purpose of the visit.

LPA Chavez conducted the initial complaint visit to the facility on 10/16/2023 and interviewed Administrator at 12:30 pm, toured the facility and requested the following documentation: Resident roster, staff schedule (LIC 500), maintenance requests/work orders, invoices, and estimates.

On the allegation: Facility did not provide safe, healthful accommodations for residents in care. LPA De Leon reviewed the interviews, documentation, emails, and pictures of the temporary unit placed in R1’s apartment which revealed the apartments air conditioning was working prior to R1 moving in the unit but once R1 moved in the air conditioning was no longer working as of July 12, 2023.

Continued 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023

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-20231016081953

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: 10/26/2023

NARRATIVE

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R1’s family brought this to the attention of the facility and has been trying to communicate the issue and get the unit fixed to no avail. The facility did put a temporary unit in the room around the end of July to early August but has not fixed the unit in the apartment. The original unit in the apartment is heating as well as air conditioning and it is not known if the heating element is working properly or not. The facility said they are trying to get quotes, has had two different Company’s out to look at the unit to replace or fix. As of October 26, 2023 nothing has been done to fix or replace the unit. The facility did not produce any maintenance requests, work orders, invoices, or estimates to CCL when requested. R1 rented the apartment with a working heating and air conditioning unit and has not had a working one since moving in. The Administrator stated the unit can not be repaired and will have to replace it. The temporary unit is still in place but it has to run out the window so once the weather gets cold it will nned to be taken out so the window can be closed and then replaced if the weather gets warmer, Administrator agreed to have staff do this for R1 until the unit is replaced and working properly. Based on the evidence this allegation is Substantiated at this time.

Exit interview conducted, copy of report and appeal rights printed for Administrator.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20231016081953

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/02/2023 Section Cited CCR 87303(a)	1 2 3 4 5 6 7	(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Administrator agreed to write up a work order, have a company come out to fix or replace the unit, provide an invoice or billing statement or purchase order and an estimated date of repair, once the new/ fixed unit is completed send a video photograph of the unit installed and working properly.
	8 9 10 11 12 13 14	Based on interview, records, and observation the licensee did not comply with the regulation above the heating and air conditioning unit in R1’s apartment is not working and has not been replaced or fixed since July 12, 2023 which possess a potential Health and Safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023

LIC9099 (FAS) - (06/04)

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