405850034-3-1-2022-29-AS-KBUY-CC7V63-20220304150849

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 03/01/2022
Date Signed: 03/01/2022 07:15:02 PM

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
07/31/2020 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20200731121328

FACILITY NAME:	AVILA SENIOR LIVING AT DOWNTOWN SLO		FACILITY NUMBER:	405850034
ADMINISTRATOR:	MARSH, CHERYL		FACILITY TYPE:	740
ADDRESS:	475 MARSH ST		TELEPHONE:	(805) 706-0736
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	100	CENSUS: 60	DATE:	03/01/2022
		UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Emily Villegas, Executive Director		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Resident’s grooming needs were not met while in care

INVESTIGATION FINDINGS:

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On 3/01/22 at 3:40 pm, Licensing Program Analyst (LPA) Chavez conducted a subsequent complaint visit to deliver final findings for the above allegation. The initial visit was conducted on 08/03/2020 by LPA Darlene Chavez. During today’s visit, LPA met with Emily Villegas, Executive Director and explained the reason for the visit.

Regarding the allegation “Resident’s grooming needs were not met while in care,” LPA Chavez conducted interviews and reviewed documentation obtained in the investigation. On 7/31/2020 at 1:16 pm, LPA interviewed the Complainant who commented about the length of R1’s nails being “very long.” Complainant was unable to provide evidence. On 8/03/2020 at 11:01 am, LPA interviewed the facility’s administrator and asked if she was aware of R1’s need for nail trimming. Administrator stated she was not aware and said that this was Wellness’ responsibility. On 02/05/22, LPA reviewed R1’s Wellness check logs for January through May 2020 which indicated that R1’s nails were trimmed on 6/07/2020.

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: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

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-20200731121328

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: 03/01/2022

NARRATIVE

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LPA obtained R1’s Needs and Services Plan and Resident Assessment dated 1/02/2020. In the Needs and Services Plan, under Grooming, the facility’s responsibility is documented as “Total Assist: Needs assist with shave.” It does not state services for nail trimming. In the Resident Assessment, the facility was responsible for “Grooming – requires 1 person total assistance with grooming.” The Assessment also does not specify services regarding nail trimming.

Based on the information and documentation obtained, there is insufficient evidence to support the above allegation. Complainant was unable to provide photos of R1’s long nails and documentation shows this was not a service required by the facility. Therefore, the allegation “Resident’s grooming needs were not met while in care” is deemed Unsubstantiated.

Exit interview conducted and a copy of this report emailed.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

LIC9099 (FAS) - (06/04)

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