565801876-5-21-2024-29-AS-DPEA-D5RRYJ-20240530132626

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801876
Report Date: 05/21/2024
Date Signed: 05/21/2024 05:46:38 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
11/03/2023 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20231103112815

FACILITY NAME:	ATRIA GRAND OAKS		FACILITY NUMBER:	565801876
ADMINISTRATOR:	BRIAN LARIOS		FACILITY TYPE:	740
ADDRESS:	2177 E THOUSAND OAKS BLVD		TELEPHONE:	(805) 370-5400
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91362
CAPACITY:	140	CENSUS: 116	DATE:	05/21/2024
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Brian Larios		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff are not following proper infection control requirements

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to the facility. The purpose of the visit is to deliver investigation finding. Upon arrival LPA met with Brian Larios and explained the reason for the visit. Entrance interview conducted.

On 11/03/2023, Community Care Licensing Division received the above complaint allegation. Investigation into the allegation consist of facility physical plant tour on 11/08/2023. Furthermore, records review, random resident and staff interviews was conducted on 11/08/2023 and 05/11/2024. Reporting party (RP) was contacted on 11/07/2023, 01/21/2024, and 05/11/2024 for additional information. Reporting party refuse to speak with LPA.

Following is a summary of the allegation and investigation finding:

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: 05/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024

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-20231103112815

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 GRAND OAKS	FACILITY NUMBER: 565801876
	VISIT DATE: 05/21/2024

NARRATIVE

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Allegation) Staff are not following proper infection control requirements. It was alleged that facility staff who tested positive for Covid on 10/28/2023 were asked to continue work a couple of day later even though staff were still having symptoms.

Staff interviewed reported that the facility policy and procedures were followed during the outbreak. Staff denied allegation and stated that no one was asked to work following a positive test result. Staff stated that after five (5) days if symptoms are better and they have no fever they were cleared to work. Facility Infection Control procedures regarding employee screening and return to work protocols reviewed reflect that staff may return to work five (5) days after a positive test if symptoms are improving and fever free without any fever-reducing medication. According to the staff interviews they were never asked to work following a positive (COVID) test result or with any COVID related symptoms. Random residents interviewed expressed that facility staff maintain proper infection control procedures. Reporting party was contacted several times through the course of the investigation to determine the validity of the allegation however RP was not willing to speak with LPA.

Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the allegation “Staff are not following proper infection control requirements” is deemed unsubstantiated at this time.

Exit interview conducted. A copy of the report provided.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024

LIC9099 (FAS) - (06/04)

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