405850034-12-24-2024-29-AS-KBUY-DDFRDF-20250131115552

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 405850034
Report Date: 12/24/2024
Date Signed: 12/24/2024 11:26:40 AM

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
12/15/2024 and conducted by Evaluator Rachael De Leon

COMPLAINT CONTROL NUMBER: 29-AS-20241215235438

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: 46	DATE:	12/24/2024
		UNANNOUNCED	TIME BEGAN:	10:46 AM
MET WITH:	Darlene Markham, Administrator		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

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Staff unlawfully evicted a resident

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

LPA De Leon conducted the initial 10-day visit on 12/20/2024, requested records, interviewed staff at 12:35pm, 12:43pm, 12:59pm, and 1:15pm, and interviewed residents around 2:00pm. On 12/23/2024 LPA requested for the Administrator to send additional discharge paperwork for Resident 1 (R1) from Mission View Skilled Nursing Facility on 12/23/2024.

On the allegation: Staff unlawfully evicted a resident. LPA received an eviction notice from Avila Senior Living dated 12/10/2024 giving Resident 1 (R1) 30 days’ notice to vacate due to the reason of R1 having a need not previously identified and a reappraisal had been conducted pursuant to Section 87463 of Title 22 of the California Code of Regulations, and stated the facility and the person whom performed the reappraisal believes that the Community is no longer appropriate for R1. Cont. 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: 12/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2024

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-20241215235438

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: 12/24/2024

NARRATIVE

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The notice stated R1 had wound care being performed by Home Health since 2022 and the wounds had progressively gotten worse becoming a Prohibited Health Condition Stage 3 dermal ulcers staged wound. R1 was sent out to the hospital for the wounds and was discharged to skilled nursing facility for treatment. The facility conducted a re-appraisal of the resident’s condition while the resident was still out of the facility and under medical care of health professionals. The licensee never arranged a meeting with the resident, the resident’s representative, facility staff, and or a representative of the resident’s home health agency, for this significant change in the resident’s condition. R1 had paid rent for the months away from the facility and wanted to return to the facility after R1’s condition improved. On 12/23/2024 R1 was discharged back to the facility with an LIC 602A physicians report signed by a health professional stagging the wound at a 2. Home Health was ordered to care for the wounds at the facility upon R1’s return. The facility does not want to rescind the eviction based on the most up to date medical records of R1. LPA explained the wounds are no longer a stage 3, the facility no longer needs an approved exception from the department to retain R1 as the prohibited health condition no longer applies to the resident at this time. The facility was able to meet the residents needs prior to the stage 3 wound. Based on the evidence this allegation is Substantiated and the eviction must be rescinded at this time.

Exit interview conducted, deficiencies 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: 12/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20241215235438

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: 12/24/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/31/2024 Section Cited CCR 87224(a)(4)	1 2 3 4 5 6 7	If, after admission, it is determined that the resident has a need not previously identified and a reappraisal has been conducted pursuant to Section 87463,... ... This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Administrator agreed to recind eviction. Eviction is considered illega, no prohibited health condition is present to allow for the eviction based on the stage 3 wound is no longer.
	8 9 10 11 12 13 14	Based on record review the Licensee did not comply with the above regulation as the facility did not do an appraisal based on the most up to date medical records on R1, the Licensee did not conduct the reappraisal with a meeting for R1’s change in condition, the facility received a new physicians report upon R1’s discharge with a stage 2 wound which poses a potential personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 12/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/24/2024

LIC9099 (FAS) - (06/04)

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