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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 04:19:57 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
10/06/2023 and conducted by Evaluator Elsie Campos
COMPLAINT CONTROL NUMBER: 29-AS-20231006100424
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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Facility is charging for services not provided.
Facility does not provide special diets to resident(s) as prescribed.
Facility staff do not have criminal record clearance.
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.

During today's complaint visit, LPA conducted interviews and reviewed pertinent documents relevant to the investigation.

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)
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Control Number 29-AS-20231006100424
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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Allegation: Facility is charging for services not provided.
Complainant alleges that the facility charges the residents and/or responsible parties for weekly maintenance including housekeeping, laundry, changing linens, and cleaning the facility further alleging that these services are not being completed by the facility while still accepting money from residents regularly. Upon arrival to the facility LPA observed that the facility was conducting a regular carpet cleaning of the facility. LPA further observed housekeeping conducting cleaning services throughout the facility. Interview with Administrator confirmed that services rendered at the facility are part of the general cost of living and all services such as housekeeping, laundry, changing linens and cleaning the facility are provided to all residents either daily or weekly depending on their personal plan of action. In addition,the facility does maintain regular and daily cleaning protocols and maintenance. Interviews with staff and residents did not express concerns with charges administered for services not rendered or with services not being completed. Interviews with residents expressed that the services are great and no issues with housekeeping. Based on interviews and LPA observation, there is insufficient evidence to support the allegation that the “facility is charging for services no provided”. Therefore, the allegation is deemed Unsubstantiated at this time.
Allegation: Facility does not provide special diets to resident(s) as prescribed.
Complainant alleges that the facility does not provide special diets to residents in care who have documented dietary requirements, which has led residents to become ill while in care. Interview with administrator revealed that special diets are comprised of low sodium, low sugar, or no sugar. Residents in care are not on diets that require special textures such as blended or chopped. All residents who require a special diet are in charge of managing what they consume. The facility will provide specialized options for residents to choose from within the parameters of the resident’s diet however, ultimately the choice of what the resident decides to eat is left up to them. Interviews with residents confirmed that they are provided options based on their special dietary needs and will opt in for them however,they do have the option to choose something else. Based on interviews, there is insufficient evidence to support the allegation that the “facility does not provide special diets to resident’s as prescribed”. Therefore, the allegation is deemed Unsubstantiated at this time.
Allegation: Facility staff do not have criminal record clearance.
Complainant alleges that Staff members employed in the facility are not associated to the facility, do not have a criminal record background check, and have not gone through the fingerprinting process prior to beginning employment at the facility. Record review conducted by LPA confirmed that all staff scheduled and on the staff roster are associated to the facility. Based on record review, there is insufficient evidence to support the allegation that the “facility staff do not have criminal record clearance”. 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)
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