565800366-9-20-2022-29-AS-DPEA-CKJNKX-20221025103240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 09/20/2022
Date Signed: 09/20/2022 10:36:35 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
02/22/2022 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 29-AS-20220222123716

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: 116	DATE:	09/20/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Denise Wadkins (Memory Care Director)		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Resident was fed a food that goes against religious beliefs

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 allegation. On 03/03/2022, LPA Z. Chochian conducted an initial 10-day complaint inspection. On today’s visit, LPA Arroyo met with Memory Care Director, Denise Wadkins. Entrance interview conducted.

During the initial inspection, on 03/03/2022, LPA Chochian requested copy of resident and staff roster. On 09/06/2022, LPA Arroyo conducted a plant tour to ensure there are no immediate health and safety concerns. Between 1:15 p.m., and 3:00 p.m., LPA conducted interviews with the Executive Director, three staff, and eleven residents. At 1:45 p.m., LPA also conducted a resident file review and obtained copies of pertinent documents relevant to the investigation. LPA attempted to interview family members on 09/06/2022 at 2:33 p.m., 09/13/2022 at 3:51 p.m., and 09/16/2022 at 3:07 p.m.

(...Report Continued on LIC 9099C...)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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-20220222123716

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: 09/20/2022

NARRATIVE

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(...Report Continued from LIC 9099...)

It was alleged that resident was fed a food that goes against religious beliefs. It was reported that Resident #1 (R1) was intentionally tricked into eating pork when it was against their religion. Information gathered revealed R1 moved out of the facility over two years ago. Additionally, record review of R1’s Admissions Agreement dated 06/16/2020 stated R1 was able to feed self. Interviews with staff revealed menus are given to residents on a daily basis and residents choose their meals. Staff stated if for any reason the resident is not happy with the food, the kitchen will accommodate them and make something else. Additionally, in the Memory Care unit, the meals for the residents go based on what they are allergic to or if the family states the resident does not like something specific. Staff stated they talk to the residents while feeding them continuously asking if they like the food as well as letting them know what they are having for their meal. Interviews with residents revealed residents are never forced to eat anything they did not like even after ordering. Residents stated they have placed their food aside and simply ask for something different. Furthermore, residents stated no concerns with the facility food or eating food they did not want to consume. Based on the information obtained and reviewed during the course of the investigation, the Department does not have sufficient evidence to support the allegation of “resident was fed a food that goes against religious beliefs”. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued. A copy of report provided via email.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

LIC9099 (FAS) - (06/04)

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