565800366-10-21-2024-29-AS-DPEA-DAHRFR-20241029125934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 10/21/2024
Date Signed: 10/21/2024 10:34:57 AM

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
02/05/2024 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 29-AS-20240205142728

FACILITY NAME:	ATRIA HILLCREST		FACILITY NUMBER:	565800366
ADMINISTRATOR:	ADAM SYNCHEFF		FACILITY TYPE:	740
ADDRESS:	405 HODENCAMP RD		TELEPHONE:	(805) 373-0606
CITY:	THOUSAND OAKS	STATE:	ZIP CODE:	91360
CAPACITY:	207	CENSUS: 126	DATE:	10/21/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Guadalupe Ambriz - Business Office Manager		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Facility is understaffed.
Due to facility staff neglect, incontinent residents are being left in soiled diapers for extended periods of time.
Unqualified staff are attending to residents.

INVESTIGATION FINDINGS:

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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 complaint visit was conducted on 02/12/2024 and a subsequent complaint visit was conducted on 10/07/2024, both by LPA M. Arroyo. On today's visit, LPA Arroyo met with Business Office Manager, Guadalupe Ambriz. Entrance interview.

During the initial visit on 02/12/2024, LPA Arroyo conducted a plant tour at 2:02pm, toured the memory care unit at 2:04 p.m., conducted interviews with the ED and four (4) staff between 1:52 p.m. and 4:25 p.m., and obtained copies of pertinent documents. On 10/07/2024, LPA Arroyo conducted interviews with three (3) staff, six (6) residents, and one (1) family member between 10:55am and 12:05pm, conducted a file review at 10:30am, and obtained copies of pertinent documents.

Report Continued on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2024

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-20240205142728

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: 10/21/2024

NARRATIVE

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Report Continued from LIC 9099...

It was alleged that facility is understaffed and unqualified staff are attending residents. It is the complainant’s concern that the memory care unit has been understaffed during the evening shifts leaving one (1) staff member to attend all residents. Additionally, the staff that is being placed in memory care, do not have the training or experience to assist the residents. Record review and interviews conducted revealed that the memory care unit typically has two (2) or three (3) staff which includes caregivers and a medication technician. Per staff schedule, dated January 2024, it confirms that there are at least two (2) staff in the memory care unit for the AM and PM shifts. Additional staff interviews revealed that although staff calls out at times, there is other staff that is able to assist. Staff stated that caregivers from the assisted living side and even outside agency staff are used at times when necessary. Staff added that the front desk clerk and kitchen staff were also used to assist in memory care; however, during interviews it was revealed that staff used from different departments only assisted by escorting residents to and from their rooms before and after meals times. Furthermore, record review of three (3) randomly selected staff hired in February 2024 revealed that staff complete all necessary training through Atria University which is an online based training. Correspondingly, randomly selected staff has completed online training as well as shadowing peers for all the required hours per regulations. And although each department requires different training, all facility staff are first aid trained upon hiring. Based on the information obtained through record review and interviews conducted, the Department does not have sufficient evidence to support the allegations of “facility is understaffed” and “underqualified staff are attending to residents”. Therefore, these allegations are deemed Unsubstantiated at this time.

It was also alleged that due to facility staff neglect, incontinent residents are being left in soiled diapers for extended periods of time. It is the complainant’s concern that staff is double briefing residents to limit the times residents are being changed. Interviews conducted with staff revealed that incontinent residents are changed every two (2) to three (3) hours. Staff stated that some residents require changing more often than others and are checked more often to ensure they are not left in soiled diapers. Staff added that they are aware of which residents require more changing as it is placed in the resident’s care plan. Interviews conducted with residents revealed that staff often check on them throughout the day and assist with their toileting needs when requested.

Report Continued on LIC 9099C...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20240205142728

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: 10/21/2024

NARRATIVE

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Report Continued from LIC 9099C...

Residents stated that they use their pendants to request for staff assistance and staff usually arrives at a decent time after the request. Furthermore, residents did not report any concerns while living at the facility. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “due to facility staff neglect, incontinent residents are being left in soiled diapers for extended periods of time”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and copy issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2024

LIC9099 (FAS) - (06/04)

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