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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 05/10/2021
Date Signed: 05/13/2021 09:32:58 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/16/2020 and conducted by Evaluator Katrina Walters
COMPLAINT CONTROL NUMBER: 21-AS-20201116102744
FACILITY NAME:ATRIA COVELL GARDENSFACILITY NUMBER:
577000881
ADMINISTRATOR:ASHLEE SLOANFACILITY TYPE:
740
ADDRESS:1111 ALVARADO AVETELEPHONE:
(530) 756-0700
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:210CENSUS: DATE:
05/10/2021
UNANNOUNCEDTIME BEGAN:
04:25 PM
MET WITH:Emily VenegasTIME COMPLETED:
04:42 PM
ALLEGATION(S):
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Personal Rights
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Walters conducted a Complaint visit on this date to deliver investigation findings regarding the above allegation. LPA spoke with Community Business Director, Emily Venegas. Executive Director, Ashlee Sloan was not availble at the time of the visit. The reader is advised that this visit was not in-person due to COVID 19 precautions.

The complaint alleges that resident (R1)'s personal rights were violated when R1's family was not allowed in-person visitation, despite R1 being diagnosed with a potential end-of-life condition. During the course of this investigation LPA Walters conducted an additional virtual visit including a tour of the facility that was conducted on 11/17/20, reviewed resident and facility records, medical documenation and communication/supporting documenation from various agencies and outside parties. In addition LPA conducted interviews with staff and various parties.

Based on interviews, documents gathered and Yolo County Public Health guidelines, LPA determined that facility had verified that they were interpreting current county and state directives accurately and allowed visitation according to those guidelines based on R1s medical documentation provided to the facility at the time of the visits.

A finding that the complaint allegation personal rights is UNSUBSTANTIATED meaning that although the allegation may have happened there is not a preponderance of evidence to prove that the allegation occurred. We have therefore dismissed the complaint.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Katrina WaltersTELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021
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 21-AS-20201116102744
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: ATRIA COVELL GARDENS
FACILITY NUMBER: 577000881
VISIT DATE: 05/10/2021
NARRATIVE
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Based on interviews, documents gathered and Yolo County Public Health guidelines, LPA determined that facility had verified that they were interpreting current county and state directives accurately and allowed visitation according to those guidelines based on R1s medical documentation provided to the facility at the time of the visits.

A finding that the complaint allegation personal rights is UNSUBSTANTIATED meaning that although the allegation may have happened there is not a preponderance of evidence to prove that the allegation occurred. We have therefore dismissed the complaint.
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Katrina WaltersTELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2