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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 07/08/2026
Date Signed: 07/08/2026 11:47:07 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, 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
06/22/2026 and conducted by Evaluator Jill Nakagawa
COMPLAINT CONTROL NUMBER: 21-AS-20260622121057
FACILITY NAME:ATRIA COVELL GARDENSFACILITY NUMBER:
577000881
ADMINISTRATOR:RICK ZIESE DULAYFACILITY TYPE:
740
ADDRESS:1111 ALVARADO AVETELEPHONE:
(530) 756-0700
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:210CENSUS: DATE:
07/08/2026
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Regional Program Manager, Carla Nuti-Martinez, Licensing Program Manager, Kimberley Mota, Licensing Program Analyst, Jill Nakagawa, Administrator, Rick Ziese-Dulay, Assistant General Counsel - Operations, Jason Thomas, Regional Vice President, Natasha Georges and Outside Counsel, Joel GoldmanTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff are not meeting resident's care needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nakagawa arrived unannounced to conduct a complaint investigation and deliver findings regarding the above allegation. LPA met with Administrator Rick Ziese-Dulay to discuss.

During the course of the investigation LPA conducted a review of records and interviews along with observations. It was found that prior to admission not to exceed fourteen (14) days, a prospective resident is assessed. If the prospective resident is found to be a two (2) person assist, they are not admitted to the facility. In addition, once a resident is admitted and becomes a two (2) person assist, safety measures such as a request for a one on one to be provided along with physical and occupational therapy oversight is provided until resident can be discharged to receive the higher level of care needed.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
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-20260622121057
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: 07/08/2026
NARRATIVE
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During LPA’s record review, there was no documentation of a resident admitted as a two (2) person assist.

Based on interviews, record review and observations, the allegation Staff are not meeting resident’s care needs is UNSUBSTANTIATED. Although the allegation may have occurred there is not a preponderance of evidence therefore the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2