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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 10/12/2023
Date Signed: 10/12/2023 04:23:09 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
06/26/2023 and conducted by Evaluator Elsie Campos
COMPLAINT CONTROL NUMBER: 29-AS-20230626105737
FACILITY NAME:ATRIA HILLCRESTFACILITY NUMBER:
565800366
ADMINISTRATOR:ADAM SYNCHEFFFACILITY TYPE:
740
ADDRESS:405 HODENCAMP RDTELEPHONE:
(805) 373-0606
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:207CENSUS: 104DATE:
10/12/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Adam SyncheffTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff force residents to do activities of daily living
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Elsie Campos conducted unannounced initial complaint investigation for the above allegations. LPA met with Executive Director, Adam Syncheff and explained the reason for the visit.

On 6/26/2023 LPA Campos conduted and intial 10 day comaplint visit in which interviews and record review were conducted. During today's complaint visit, LPA conducted interviews, reviewed pertinent documents and delivered findings.

Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jeralyn Ann PfannenstielTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Elsie CamposTELEPHONE: (747) 230-3909
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
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 29-AS-20230626105737
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: 10/12/2023
NARRATIVE
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Staff force residents to do activities of daily living.

Complainant alleges that staff are instructed to force residents to participate and engage in activities of daily living. Interviews with staff and residents denied claims that they are forced to do activities of daily living. Interviews with residents confirmed that they are allowed to make their own decisions and participate at their leisure. Staff interviews indicated that although some residents may have specific care instructions they are never forced to bathe or change against their will. Staff will always attempt to work with the resident and with management in addressing the residents care needs and concerns with non-compliance. Resident interviews denied claims that they are forced to do any forms of activities of daily living and will only be encouraged or given the option to participate if they wish. Based on interviews, there is insufficient evidence to support the allegation that the “staff force residents to do activities of daily living”. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISOR'S NAME: Jeralyn Ann PfannenstielTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Elsie CamposTELEPHONE: (747) 230-3909
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2