405850034-4-19-2024-29-AS-KBUY-D5GUJD-20240521153721

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 04/19/2024
Date Signed: 04/19/2024 03:46:54 PM

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
03/05/2024 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20240305115814

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: 47	DATE:	04/19/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Facility does not keep apartments clean, safe, sanitary and in good repair.

INVESTIGATION FINDINGS:

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

LPA De Leon conducted the initial complaint visit on 03/11/2024 and interviewed staff around 12:00pm, toured the facility rooms in question and requested additional documentation.

On the allegation: Facility does not keep apartments clean, safe, sanitary and in good repair. LPA's tour and observation on 03/11/2024 revealed that apartments 255/256 did have some repair work done in the bathrooms and LPA needed further time to investigate. F1 stated some work had been done but the water coming out of the shower area had made the recently replaced dry wall and trim wet again in one of the bathrooms and the other bathroom needed caulking in the gap between the floor and the shower. F1 used a moisture meter in the bathroom areas noting several areas still had moisture issues in areas around the shower areas in one of the bathroom and submitted a new work order for repairs. 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: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

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-20240305115814

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: 04/19/2024

NARRATIVE

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S2 addressed the work order and completed additional work in those apartments bathrooms. F1 was satisfied with the additional work preformed at that time. Based on the evidence this allegation is Substantiated at this time.

A deficiency was issued on prior complaint #29-AS-20240119140915 regarding the physical plant repairs and it addressed these two apartments bathrooms. The POC is being cleared as of 04/18/2024 as all repairs have now been completed and documentation was sent to CCL. Another deficiency will not be issued at this time.

Exit interview completed, 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: 04/19/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2024

LIC9099 (FAS) - (06/04)

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