565800366-8-29-2023-29-AS-DPEA-CW6384-20230929180054

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 08/29/2023
Date Signed: 08/29/2023 11:37:25 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
10/26/2022 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20221026160036

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: 107	DATE:	08/29/2023
		UNANNOUNCED	TIME BEGAN:	09:54 AM
MET WITH:	Adam Syncheff, Executive Director		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff not present to administer medication to residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a complaint visit to the above facility. The purpose of the visit is to conclude investigation and issue investigation finding regarding above allegation. LPA met with Adam Syncheff, Executive Director, and reason for the visit was discussed. On 10/26/22, information was reported that there is no medtech available from 10am-6am therefore residents must wait 30min to an hour for a medtech to come from the sister facility and administer pain medication to resident(s). Investigation into this allegation consists of records review, interview with staff and random residents. During the initial visit on 11/04/2022, LPA conducted interview with ten (10) residents and reviewed facility staffing schedule. Ten (10) out ten (10) residents interviewed reported no issues with receiving medication during the night. Staff interviews conducted on 11/04/2022 and 08/21/2023 reported that there is a medtech available during the noc shift to administer pain medication to resident when needed. Staffing schedule reviewed confirmed that there is a medtech schedule for noc shift duty.
Based on the information gathered above there is insufficient evidence to support the allegation. Therefore, allegation is deemed unsubstantiated at this time. Exit interview held. Copy of report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

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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