405850034-5-10-2024-29-AS-KBUY-D5GTZW-20240521151101

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 05/10/2024
Date Signed: 05/10/2024 02:44:35 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
05/06/2024 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20240506140201

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:	05/10/2024
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility does not have hot water.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) De Leon conducted a 10-day complaint visit to the facility above. LPA was greeted by Business Office Manager working the front desk and LPA was told the Administrator was in a meeting and would be right with LPA. Administrator finished meeting and met with LPA. LPA explained the purpose of visit.

LPA requested the following records: Resident Roster, Staff Roster with Telephone numbers, Estimates or Invoices, Bids, Work Orders, Emails to RP/Residents notifying about Hot water, and Corporate approval of estimate.

LPA took tour of the residents room and tested the water temperature in each bathroom toured.
At 11:00 am Room 153 bathroom faucet took 9 minutes to get a reading of 107.3 F at 11:09 am. At 11:22 am room 156 water measured at 101.6 F. At 11:31 am room 158 water measured at 65.1 F. At 11:36 am room 150 measured at 70.1 F. At 11:47 am room 257 water measured at 98.3 F.
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: 05/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

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 3

Control Number 29-AS-20240506140201

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: 05/10/2024

NARRATIVE

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At 11:57 am room 253 water measured at 120.2 F. At 12:05pm room 250 measured at 109.8 F. At 12:08 pm room 263 water measured at 70.3 F. At 12:13 pm room 350 measured at 119.2 F. At 12:16pm room 353 measured at 115.8 F. At 12:20 pm room 356 measured at 98.1 F. At 12:24 pm room 360 measured at 69.4 F. At 12:35pm LPA measured the common bathrooms by the dining room bathroom #1 measured at 130.4 F and bathroom #2 measured at 129.4 F.

On the allegation: Facility does not have hot water. Based on interviews with staff the facility placed a sign up by the front desk on 05/02/2024 that the facility water would be shut off for 2 hours to fix a pipe. LPA was at the facility at that time and the water was restored before LPA left the facility. Later that day another pipe broke on the 4th floor and it was fixed immediately the same day. On Friday 05/03/2024 there were no reports of not having hot water at the facility. On Saturday 05/04/2024 Administrator was called in to the facility due to the hot water not working that morning. Administrator called a plumber that came out to the facility, the plumber reset the pump on the 4th floor and it took a little while but the hot water was restored. The maintenance staff measured the water through out the Atrium rooms affected and water temperature measured between 105-107.0 F. The plumber stated to the facility it could be the pump burning out so let him know if it stops working again. On Sunday 05/05/2024 the hot water went out again and the Administrator came in and called the plumber and reset the pump again and the hot water worked again, the maintenance staff tested water through out the facility and got reading all over the place so the plumber said he would try to find the right parts and get them ordered in the meantime when the hot water goes out try to reset the pump. The facility has been resetting the pump daily to get as much hot water to the apartment as they can until the part comes in to fix the pump. Administrator said it has only affected the atrium apartments and the Administrator notified everyone and gave alternatives if the water was not hot enough they could use vacant apartments to shower, several residents have done so. The Administrator is doing whatever the facility can to accommodate the residents by using a vacant apartment till it is working correctly or using a vacant apartment shower if their showers are not getting hot enough. LPA's observation in measuring water temperature shows the facility is not meeting the required 105-120 degrees F throughout the facility apartments. This allegation is deemed Substantiated at this time.

Exit interview conducted, deficiency cited, 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: 05/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20240506140201

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: 05/10/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/11/2024 Section Cited CCR 87303(e)(2)	1 2 3 4 5 6 7	(e)...:(2)... temperature controls shall be maintained...hot water used by residents to attain a temperature of not less than 105 degree F (41 degree C) and not more than 120 degree F (49 degree C). This requirement has not met as evidenced by:	1 2 3 4 5 6 7	Administrator agreed to continue to work with plumber and maintenance staff to get the parts installed and the hot water working properly through out the Atrium in all apartments to measure within regulation of 105-120 F. Send plumbers invoice and water temperature log reading for 5 days
	8 9 10 11 12 13 14	Based on observation and staff interviews the Licensee did not comply with the regulation above the residents hot water measured at different temperatures throughout the atrium not within regulation requirements which poses a potential Health, Safety and Personal Rights risk to residents in care.	8 9 10 11 12 13 14	during the AM/Noon/PM shifts to CCL.
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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: 05/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2024

LIC9099 (FAS) - (06/04)

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