577000881-2-1-2024-21-AS-VBEI-D2UUDF-20240227142927

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 02/01/2024
Date Signed: 02/01/2024 12:59:47 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
01/31/2024 and conducted by Evaluator Jill Nakagawa

COMPLAINT CONTROL NUMBER: 21-AS-20240131120921

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: 146	DATE:	02/01/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Barbara Fleck, Administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not providing adequate care and supervision to the residents
Facility is not clean and sanitary

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Nakagawa arrived unannounced at Atria Covell Gardens on 2/1/24 at approximately 9:15 AM to conduct an investigation regarding the above allegations. LPA met with Administrator Barbara Fleck who allowed access to the facility and provided LPA with an immediate tour.

LPA made a tour of the facility, including the dining room, common areas and the Memory Care unit.

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: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

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-20240131120921

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: 02/01/2024

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

It is alleged Staff are not providing adequate care and supervision to the residents. The reporting party states that residents in Memory Care are locked in their rooms due to a Covid outbreak. LPA toured the facility, focusing on the Memory Care unit. LPA made observations, reviewed documents and conducted interviews. It was reported to LPA that residents in Memory Care were asked to isolate in their rooms due to cases of Covid on the unit, under the direction of Public Health. Residents are not locked in their rooms as they are not locked from the inside. They are currently locked form the outside to assist in keeping residents separated from other residents who may be infectious.

The reporting party stated that residents are not being cared for, checked on, helped to the bathroom, or given water. LPA found residents to be clean, groomed and dressed appropriately. At the time of inspection ,it appeared that residents had recently been served breakfast, which included a selection of beverages (water, juices). There were 7 staff at the time of inspection, who were all engaged in duties of care, housekeeping and activities. It was reported to L PA that Lunch and Dinner are also served, with beverages. There are also 3 snacks/hydration breaks throughout the day. Additionally, residents are checked regularly for hygiene and hydration and there are call buttons in the bathrooms.

It is also alleged that Facility is not clean and sanitary. The reporting party stated that they are living in filthy conditions. At the time of inspection the facility was found to be clean, comfortable and well-maintained. Bathrooms were clean and sanitary. Sinks, toilets and showers were clean, and wastebaskets were empty and lined. Bedrooms were neat and tidy. Most beds were made, except for several rooms where residents were resting. Common areas in Memory Care were clean, including dining room; kitchen and serving area were also clean and sanitary.

Although the allegations may be true, based on observations, statements and documents, there is not a preponderance of evidence to prove the allegations true or false therefore the complaint is UNSUBSTANTIATED.

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill Nakagawa	TELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2