405850034-10-29-2024-29-AS-KBUY-DAJQEL-20241030120631

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 10/29/2024
Date Signed: 10/29/2024 03:33:04 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
05/16/2024 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20240516171352

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: 44	DATE:	10/29/2024
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Illegal Eviction
Facility is retaliating against Resident Council member

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 allegations. LPA met with Darlene Markham, Administrator and explained the purpose of the visit.

LPA De Leon conducted the initial 10-day visit on 05/23/2024, collected records, conducted interviews with Staff at 2:15pm, 2:45pm, 3:00pm, and later that afternoon. LPA interviewed residents on 05/14/2024 at 11:28am, on 05/16/2024 at 11:15am and 11:56am, on 05/28/2024 at 1:40pm, and on 05/30/2024 at 11:09am. LPA interviewed staff on 06/20/2024 at 2:15pm and residents at 3:00pm and 3:09pm.

On the allegation: Illegal Eviction. LPA De Leon investigated the reasons listed on the eviction notice for Resident 1 (R1). The following dates were listed on the eviction notices and followed by LPA’s investigation as these were the allegations for the cause of eviction:
Continued 9099-C

Unsubstantiated

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: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

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 4

Control Number 29-AS-20240516171352

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: 10/29/2024

NARRATIVE

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February 19, 2024 - R1 yelled and cursed at a Med-Tech about a PRN. R1 asserted the PRN was able to be given 3x’s a day, but the Med-tech only had an order for 2x’s a day, and staff stated they were not able to give it again. This date and incident turned into a complaint allegation for complaint # 29-AS-20240306103155. It was Substantiated that medication was not given as prescribed, due to the doctors’ order for the PRN to be given 3x’s per day as needed. Interviews, including an interview with R1, confirmed that R1 did yell and curse at the Med-Tech that day due to R1 being in pain and needing the PRN medication.

February 17, 2024 - R1 yelling, shouting, and cursing at a resident in the dining room. LPA interviewed 7 residents and 4 out of 7 stated this incident did occur, and other residents interviewed were not in the dining room at this time or do not recall hearing R1 yelling and cussing at a resident. Based on interviews, R2’s cell phone was ringing in the dining room, R2 answered it on speaker phone and had been waiting for the call when R1 yelled across the room, “Turn the fucking phone off.” R2 avoids being around R1 due to R1’s rude, controlling, and intimidating behavior. Several residents stated R1 does try to control or police the dining room cell phone usage. Several interviews noted R1 to be a “bully” and a few said R1 “intimidates” residents.

On December 6, 2023 - Meeting held with Administrator, Business office Manager, R1 and Ombudsman for the reasons of yelling at residents and staff, as well as inappropriate behavior. LPA observed a record of the meeting with signatures acknowledging the meeting only. R1 did respond with a written note on the grievance letter, and was not in agreement to the letter or the dates indicated on the grievance. LPA interviewed 6 residents which revealed 3 out of 6 residents observed R1 yelled at residents and/or staff on a few occasions. 2 out of 6 residents stated R1 did display inappropriate behavior when voting for employee of the month. LPA interviewed 4 out of 5 staff which revealed R1 has yelled at residents and staff on a few occasions.

On September 21, 2023 - A meeting was held with Administrator, Resident Services Director, Activities Director, Business Office Manager, Ombudsman and R1 regarding yelling at staff in front of residents. LPA De Leon interviewed residents and staff which revealed R1 yelling at staff in front of other residents on a few occasions. Staff interviews revealed S2 was helping a new resident, who required special accommodations, with an activity when R1 yelled across the room that S2 was cheating due to helping the resident. Interviews revealed R1 has yelled and cussed at residents in activities, and due to R1 being rude, several residents do not participate in certain activities due to R1. Continued 9099-C

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20240516171352

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: 10/29/2024

NARRATIVE

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On June 6, 2023 - R1 became upset and pushed another resident. On 06/13/2023 a meeting was held with R1 and Acting Executive Director at the time, house rules were reviewed and initialed. R1 does not agree to this incident happening the way it was explained in the meeting.

LPA received a copy of a written correspondence from a facility resident stating that R1 is admired for how R1 participates in Resident Council meetings but have found R1 to be a bully when reprimanding residents in the dining room for cell phone usage.

LPA reviewed records from the facility. LPA has a house rules sheet signed by R1 dated 02/18/2021, R1 has an additional House Rules initialed on 06/13/2023, and on a grievance letter dated 12/06/2023 acknowledging a meeting was held only, in which the house rules were addressed for “#5 Be thoughtful and considerate of others in the community with appropriate language, comments and remarks.” This letter also mentions multiple dates to include 03/29/2022, 04/26/2022, 09/13/2023 and 09/21/2023 when they had meetings with R1 regarding behaviors towards staff and residents. R1 did not agree and made notes on a copy of the grievance.

LPA reviewed staff charting notes from R1’s admission date of 02/26/2021 to 05/02/2024. R1 had 20 entries of issues with behaviors. Other incidents not already discussed included the following:

On March 29, 2022 - According to charting notes on this date a note of behavior was made Re: A meeting was held with the administrator, R1 and R1’s representative regarding an increase in care fees and R1’s behavior. It had been reported to the Administrator that R1 had been rude to with staff and causing issues in the building with some residents, getting too involved with their personal needs, families had been upset and called administrator asking that R1 stay out of their loved ones (residents’) personal business.

On April 26, 2022 - According to charting notes on this date a note of appointment was made Re: Meeting with Ombudsman, R1, and the operations specialist for Pacifica regarding R1’s behaviors, residents and families complaining R1 is over-stepping boundaries, staff complaints of R1’s rudeness in talking with them, yelling at front desk staff, and being disrespectful to the Executive Director at the front desk. Meeting ended and it was agreed upon R1 agreed to meet once a week to see R1’s improvement. Document states overall R1 seems unhappy at the facility and maybe need to look for a different community.
Continued 9099-C

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Rachael De Leon	TELEPHONE: (805) 450-0262
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20240516171352

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: 10/29/2024

NARRATIVE

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On September 13, 2023 - According to charting notes on this date a note of behavior was made Re: R1 was heard yelling, having an outburst towards the staff activities director (AD) in front of a room of residents. R1 yelled at AD about some changes in the activities calendar that AD had made, Executive Director spoke with R1, letting R1 know the behavior was inappropriate. R1 was also upset the transportation van did not run on Saturdays. ED educated R1 the AD does not work weekends and the assistant does activities in the facility on the weekends, so the facility does not run the transportation van on those days.

The facility met with R1 on several occasions to seek remedy and compliance with house rules before issuing an eviction notice dated February 23, 2024. According to R1’s admission agreement it states, “the Community may upon thirty (30) day written notice, terminate the agreement if we determine that you have failed to comply with the general policies of the community.”

Therefore, this allegation is deemed Unsubstantiated at this time and is not considered an illegal eviction.

On the allegation: Facility is retaliating against Resident Council member. LPA conducted interviews with staff and residents which revealed R1 took being a Council Member very seriously. One resident stated they admired the way R1 participated in council meetings, no one had any issues with council meetings or R1 in the council meetings. LPA investigated all the dates in the eviction letter and only the 12/6/2023 date was related to Resident Council. It was in regard to R1 voting several times for the employee of the month, when only one vote per resident was allowed. Another incident brought up in staff interviews revealed when another resident was running against R1 for resident council, the resident put a photograph and information at the front desk area and R1 wrote on the photograph.

LPA has found no evidence to support the allegation and therefore it is Unsubstantiated at this time.

Exit interview conducted and copy of report 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: 10/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2024

LIC9099 (FAS) - (06/04)

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