435200731-4-4-2023-26-AS-KHOS-DGLJZL-20250512072940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 435200731
Report Date: 04/04/2023
Date Signed: 04/04/2023 12:28:27 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/27/2023 and conducted by Evaluator David Marrufo

COMPLAINT CONTROL NUMBER: 26-AS-20230327165532

FACILITY NAME:	ATRIA SUNNYVALE		FACILITY NUMBER:	435200731
ADMINISTRATOR:	FLAVIO SILVA		FACILITY TYPE:	740
ADDRESS:	175 E REMINGTON DR		TELEPHONE:	(408) 738-3410
CITY:	SUNNYVALE	STATE: CA	ZIP CODE:	94087
CAPACITY:	160	CENSUS: 67	DATE:	04/04/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kris Waluszko		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Resident is being financially abused

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Marrufo conducted an unannounced complaint investigation visit and met with Kris Waluszko, Regional Vice President..

During visit, LPA Marrufo interviewed residents R1-R6, Staff S1-S9, and R1's Family Member, FM1. During interviews, Residents R2-R6 stated to have not had any recent incidents of bank fraud, to have not had their personal banking information stolen, nor to have suspected any staff of stealing any of their personal belongings from their living units. Staff S1-S9 stated to have not observed any staff or residents report any incidents of bank fraud, theft of personal banking information, or theft of personal belongings from their living units.

See LIC9099-C for more information. Page 1 of 2.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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 26-AS-20230327165532

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131

FACILITY NAME: ATRIA SUNNYVALE	FACILITY NUMBER: 435200731
	VISIT DATE: 04/04/2023

NARRATIVE

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Resident R1 stated to have recently experienced an incident of fraudulent bank charges and stolen banking information. R1 stated to have clicked on an pop-up alert while checking email on R1's computer. R1 stated the pop-up alertt stated that there was a fraud alert on R1's banking account and R1 called the telephone number that was on the pop-up alert. R1 stated that the person on the telephone call directed R1 to provide personal banking information. R1 stated that there were then fraudulent banking charges made on R1's bank account. R1 stated that FM1 called R1's bank to freeze the account.

LPA Marrufo conducted a telephone interview with FM1 during the facility visit. FM1 stated that R1 had called a telephone number that was on a pop-up alert that appeared on R1's computer while R1 was checking email. FM1 stated the person on the phone directed R1 to provide sensitive banking information. FM1 stated to have called R1's bank to freeze R1's account. FM1 stated the fraudulent charges on R1's bank account were not done using R1's physical checking account card.

During interview, Regional Vice President Kris Waluszko stated to have not heard any reports of R1 experiencing bank fraud or theft of banking information.

This agency has investigated the complaint allegation listed. Based on interviews and review of records, the CCLD has found that the complaint allegation is unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

This report was reviewed with Kris Waluszko, Regional Vice President, and a copy of the report was provided.

Page 2 of 2. END REPORT.

SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2