565800366-12-13-2021-29-AS-JAPL-C9NW4X-20211213155816

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 12/13/2021
Date Signed: 12/13/2021 11:55:54 AM

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
12/16/2020 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20201216102550

FACILITY NAME:	ATRIA HILLCREST		FACILITY NUMBER:	565800366
ADMINISTRATOR:	SARAH DODD		FACILITY TYPE:	740
ADDRESS:	405 HODENCAMP RD		TELEPHONE:	(805) 373-0606
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	207	CENSUS: 110	DATE:	12/13/2021
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Sarah Dodd		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not appropriately care for resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Smith arrived unannounced for a subsequent complaint visit to deliver findings. The LPA met with Executive Director Sarah Dodd and explained the reason for the visit.

During an initial virtual visit conducted on 12/28/2020, LPA Aja Richardson interviewed the Executive Director and requested documents. During a visit on 8/13/2021, the LPA conducted, a tour, collected documents, interviewed staff at 10:30 a.m. and 10:44 a.m., interviewed a resident at 11:15 a.m. and interviewed a private companion at 11:20 a.m. During the visit conducted on 12/12/2021, the LPA interviewed three (3) staff from 10:55 a.m. – 11:45 a.m., and interviewed thirteen (13) residents from 11:16 a.m. – 1:30 p.m. Lastly, the LPA spoke with Resident #1 (R1) on 12/12/2021 at 4:00 p.m., and a responsible party for R1 was interviewed on 12/12/2021 at 12:16 p.m.

CONT 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

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-20201216102550

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: 12/13/2021

NARRATIVE

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Regarding the above allegation, it was alleged that staff failed to appropriately care for Resident #1 (R1). Interviews conducted with R1 and R1’s responsible party could not corroborate such claims, as neither party was unable to provide specifics as to how their care needs were not met. Whereas there were concerns voiced regarding R1 advocating for themselves and being heard by staff at this facility, information obtained did not support claims that staff failed to appropriately care for R1.

Resident interviews revealed that residents felt comfortable residing in this facility and confirmed that they encountered appropriate interactions from the staff. Residents feel that staff were professional and respectful, and felt that that staff maintained appropriate relationships and boundaries with the residents. Residents denied claims that their needs were not met and felt that they received appropriate care at this facility. Staff claimed that they all worked together to ensure that resident needs were met at all time, and denied claims that staff failed to meet the needs of any resident, including R1.

Based on the information obtained, there is insufficient evidence to support the claim that staff did not appropriately care for R1. This allegation is deemed Unsubstantiated at this time.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2021

LIC9099 (FAS) - (06/04)

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