577000881-9-18-2023-21-AS-KMOA-CWCR5C-20231006124256

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 09/18/2023
Date Signed: 09/18/2023 12:55:54 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/14/2023 and conducted by Evaluator Jill Nakagawa

COMPLAINT CONTROL NUMBER: 21-AS-20230914101349

FACILITY NAME:	ATRIA COVELL GARDENS		FACILITY NUMBER:	577000881
ADMINISTRATOR:	BARBARA FLECK		FACILITY TYPE:	740
ADDRESS:	1111 ALVARADO AVE		TELEPHONE:	(530) 756-0700
CITY:	DAVIS	STATE: CA	ZIP CODE:	95616
CAPACITY:	210	CENSUS: 143	DATE:	09/18/2023
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Barbara Fleck, Administrator		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not providing food service for the residents

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced on 9/18/23 at approximately 10:05 AM to open a complaint regarding the above allegation.

The allegation states that Staff are not providing food service for the residents. and that as of Sep 12 dining room service is not being provided.

Continued on 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill Nakagawa	TELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

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-20230914101349

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ATRIA COVELL GARDENS	FACILITY NUMBER: 577000881
	VISIT DATE: 09/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Continued....

Allegation states that actions are because of Covid but no emergency health orders are in place.

LPA conducted interviews, reviewed documents and found that at the current time, the facility is mitigating the spread of the Covid virus, as outlined in their Infection Control Plan. One way to cut down on the spread of the virus is to limit contact. A contact is considered 15 minutes exposure with a positive individual over the course of 24 hours. If residents are eating meals together, without masks, of course, there is a higher likelihood of someone unknowingly spreading the virus to others, as residents tend to socialize and linger over their meals together.

The Department of Social Services advises Licensees to go by the strictest guidelines: the State Dept of Health, the CDC or the County Health Department. It was recommended by the Yolo County Health Department to close the communal dining areas to help mitigate the spread. This is within operating procedures, if warranted. As stated in CCR:

87555: General Food Service Requirements

(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.

(b) The following food service requirements shall apply:
(4) Meals on the premises shall be served in a designated dining area suitable for the purpose and residents encouraged to have meals with other residents. Tray service shall be provided in case of temporary need.

87470 Infection Control Requirements

(a) A licensee shall ensure that infection control practices are maintained as follows:
(c) An Infection Control Plan shall be developed by the licensee and shall be included in the Plan of Operation required by Section 87208.
(1) The Infection Control Plan shall include all of the following:
(E) The licensee shall ensure that staff encourage residents to
follow infection control practices as necessary.

Tray service is currently being provided to each resident. Orders are taken daily and a written record of food being delivered to each resident has been kept. Therefore LPA confirmed that food service is being provided to the residents as well as following the guidance of the Health Department. Although the allegation may be valid, there is not a preponderance of evidence to prove the alleged violations did, or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill Nakagawa	TELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2