565800366-3-14-2023-29-AS-DPEA-CQ8VKF-20230324163017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 03/14/2023
Date Signed: 03/14/2023 05:52:58 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
12/08/2022 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 29-AS-20221208092916

FACILITY NAME:	ATRIA HILLCREST		FACILITY NUMBER:	565800366
ADMINISTRATOR:	BRIAN A LARIOS		FACILITY TYPE:	740
ADDRESS:	405 HODENCAMP RD		TELEPHONE:	(805) 373-0606
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	207	CENSUS: 102	DATE:	03/14/2023
		UNANNOUNCED	TIME BEGAN:	05:00 PM
MET WITH:	Adam Syncheff		TIME COMPLETED:	06:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not following resident's admissions agreement.
Staff are not providing resident's an itemized list of fees.
Staff did not provide residents rent increase notice within 60 days.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. The initial visit was conducted on 12/12/2022 by LPA M. Arroyo. During today’s visit, LPA Arroyo met with Executive Director, Adam Syncheff. Entrance interview conducted.

During the initial visit on 12/12/2022, LPA Arroyo conducted interviews with the Executive Director (ED), Business Director (BD), six residents, and obtained a copy of the census and other pertinent documents relevant to the investigation between 1:49pm and 3:10pm. On 02/13/2023, LPA conducted interviews with family members at 2:13pm, 2:47pm, 3:31pm, and 4:05pm.

Report Continued on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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 3

Control Number 29-AS-20221208092916

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: ATRIA HILLCREST	FACILITY NUMBER: 565800366
	VISIT DATE: 03/14/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Report Continued from LIC 9099...

It was alleged that staff are not following resident's admissions agreement. It was reported that in the admissions agreement, it states the facility will provide activities for all residents as well as transportation. Record review of admissions agreement revealed the facility outlines the standard services that are included with the monthly rate on page 5 of 44. Per the facility’s admissions agreement, it is notated that planned activity programs including assistance with arrangement for utilization of local resources and assistance in arranging your transportation to medical and dental appointments, shopping and recreational facilities, and religious activities is offered to all residents. Interviews with residents revealed activities are being offered by the facility; however, there are certain activities residents enjoy participating in and would like the facility to offer them more often throughout the week. Additionally, residents stated the facility has drivers only on Tuesdays and Thursdays and anything outside of those two (2) days would require the resident to schedule transportation with Dial-a-Ride. However, residents reported the facility is assisting them in making the arrangements. Based on interviews and record review, the Department does not have sufficient evidence to support the allegation of “staff are not following resident’s admissions agreement”. Therefore, the allegation is deemed Unsubstantiated at this time.

It was also alleged that staff are not providing resident's an itemized list of fees. It was reported that facility has charged services but does not provide residents with a breakdown of how the amounts are being calculated. Interviews with staff revealed the monthly bills are sent out directly from corporate and everything is itemized including the basic care plan and anything else that was added or included as an additional fee. Interviews conducted with family members revealed the monthly bills they receive are informative and the bill indicates exactly what service and day it was provided. Additionally, interviews with residents revealed their family members have communicated with the residents to confirm if extra charges on the monthly bill were provided to them. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “staff are not providing resident’s an itemized list of fees”. Therefore, the allegation is deemed Unsubstantiated at this time.

Report Continued on LIC 9099C...

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20221208092916

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: ATRIA HILLCREST	FACILITY NUMBER: 565800366
	VISIT DATE: 03/14/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Report Continued from LIC 9099C...

It was further alleged that staff did not provide residents rent increase notice within 60 days. It was reported that staff has given the residents a notice of rent increase that is in effect as of January 1, 2023; however, the residents did not receive the notice until November 3, 2022. Record review revealed the facility sent a notice of rent increase to every resident and/or resident’s power of attorney on October 27th, 2022. Each notice includes the date, resident’s name, person notice/letter being addressed to, along with an explanation of rent increase and updated/new schedule of fees effective January 1st, 2023. Additionally, a review of random resident admissions agreement revealed that every agreement includes Attachment K on page 36, which is the facility’s rate increase history disclosure for the past three (3) years. Interviews conducted with staff revealed the facility had sent out the rent increase notice to all residents in October for the rent increase that will take effect in January. However, staff reported a few residents that did not receive the notice, but only because those residents recently moved in and the new rate increase has gone into effect on their admissions agreement. Furthermore, during interviews conducted with residents and family members, both residents and family members acknowledged receiving the rent increase notice in October. Based on the information and documentation obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “staff did not provide residents rent increase notice within 60 days”. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued. Report was reviewed and issued to the Executive Director.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3