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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 05/23/2024
Date Signed: 05/23/2024 12:37:07 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
04/04/2023 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20230404090321
FACILITY NAME:AVILA SENIOR LIVING AT DOWNTOWN SLOFACILITY NUMBER:
405850034
ADMINISTRATOR:ERIKA HAMPEFACILITY TYPE:
740
ADDRESS:475 MARSH STTELEPHONE:
(805) 541-4222
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY:100CENSUS: 48DATE:
05/23/2024
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Darlene Markham, AdministratorTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff are interfering with the residents' medical decisions while in care
Facility staff violated residents' right to visitation
INVESTIGATION FINDINGS:
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Licnesing Program Analyst (LPA) De Leon conducted a subsequent visit to the facility above to deliver an amended report to the facility. LPA met with Administrator Darlene Markham and explained the purpose of the visit.

This is an amended report. On 10/6/23 at 2:20 pm, Licensing Program Analyst (LPA) Chavez conducted an unannounced follow-up visit to deliver final findings for the original complaint dated 4/4/2023. To investigate, LPA interviewed the administrator, residents, and staff. Interviews were conducted on 4/4/23 at 11:08 am and on 4/11/23 between 1:21 pm to 4:00 pm. LPA met with Darlene Markham, Administrator/Executive Director, and explained the purpose of the visit.

On the allegation, “Staff are interfering with the residents' medical decisions while in care.” The investigation revealed that the facility was using an Alternate Pharmacy Waiver, which required residents to use the facility’s preferred pharmacy or incur a $200 per month additional fee. The investigation did not find sufficient evidence to prove that staff interfered with residents’ medical decisions. Continued 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De LeonTELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
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 2
Control Number 29-AS-20230404090321
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: 05/23/2024
NARRATIVE
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However, the investigation revealed the Alternate Pharmacy Waiver was not in the original Admission Agreement submitted to CCL during licensure. The facility is required to submit changes to their Plan of Operation and Admission Agreement to CCL before implementation. This will be addressed on a separate case management visit. Based on the information obtained, the allegation is deemed Unsubstantiated at this time.

On the allegation, “Facility staff violated residents' right to visitation,” the complainant’s concern was that resident’s visitation rights were violated due to a letter distributed by the interim administrator. According to the complainant, the letter stated media and reporters are not allowed on the property without prior consent, which is a violation of resident’s right to visitation.
LPA reviewed the letter from the interim Administrator. The letter states “Our community is private property and members of the media/reporters are not allowed to walk into or around our property asking questions without prior consent.” The letter also states, “If you need to talk with someone please come to me directly” and provides the Administrator’s contact information.
The licensee has an obligation to ensure resident’s physical and mental health, physical safety and general welfare pursuant to Health and Safety Code 1569.2(c) and 1569.312(a). Regulation 87468(a)(11) states residents have the right to visitors, ombudsman, and advocacy representatives permitted to “visit privately during reasonable hours and without notice, provided that the rights of other residents are not infringed upon.” The media is not an entity within the scope of those with an affirmative right to enter the facility without a specific resident’s invitation. Residents have the right to be notified of potential visitors seeking to visit, and then decide to accept or decline the visit. Residents have a right to make informed choices regarding visitation including the media/press.
If a resident accepts the visit, the facility has the obligation to provide a safe and private location for the visit, where other residents’ rights to privacy will be not infringed upon. Additionally, a resident’s image could be captured and published by the media via photography or broadcast, and it is imperative to ensure the resident knowingly and competently consents to the use of their identity and image. In some cases, it would be appropriate for the facility to contact a resident’s Power of Attorney to inform them of the request.
The facility should also ensure all residents safety and dignity is protected in that after the media/press are done visiting the specific resident that allowed visitation, they should not wander freely around the building, attempting to interview residents who have not consented to the visit/interview. Based on interviews conducted, no residents requested visits/interviews from the media.
Based on evidence obtained, the allegation is deemed Unsubstantiated at this time.
Exit interview conducted, report given.
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De LeonTELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2024
LIC9099 (FAS) - (06/04)
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