577000881-7-9-2025-21-AS-KMOA-DJMQE3-20250716120541

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 07/09/2025
Date Signed: 07/09/2025 01:04:03 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
05/12/2025 and conducted by Evaluator Jill Nakagawa

COMPLAINT CONTROL NUMBER: 21-AS-20250512101522

FACILITY NAME:	ATRIA COVELL GARDENS		FACILITY NUMBER:	577000881
ADMINISTRATOR:	CAROL DOWELL		FACILITY TYPE:	740
ADDRESS:	1111 ALVARADO AVE		TELEPHONE:	(530) 756-0700
CITY:	DAVIS	STATE: CA	ZIP CODE:	95616
CAPACITY:	210	CENSUS: 142	DATE:	07/09/2025
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Karrie Silvey, Executive Director		TIME COMPLETED:	12:55 PM

ALLEGATION(S):

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Facility did not issue a refund to a resident in care.
Facility charged resident for services not rendered

INVESTIGATION FINDINGS:

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On 7/9/2025, Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to continue an investigation and deliver findings regarding the above allegations. LPA met with Karrie Silvey, Executive Director, to discuss the findings.
The complaint alleges that Facility did not issue a refund to a resident in care. Resident R1 was out of the facility for two nights in hospital but was charged by the facility for receiving care. LPA reviewed the lease agreement signed by R1 which specifies that there are no refunds regarding care costs when a resident is away from the facility, including hospital stays, vacations, etc. Therefore, the allegation that the Facility did not issue a refund to a resident in care is Unsubstantiated.
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: 07/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025

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 21-AS-20250512101522

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: 07/09/2025

NARRATIVE

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Continued from 9099...

In addition, the complaint alleges Facility charged resident for services not rendered. The complaint states R1 was charged for one month, including care costs, although R1 moved out of the facility because the facility could not meet R1’s care needs due to medical condition.

LPA reviewed the Admissions Agreement signed by R1 which states that a 30-day notice must be given when a resident chooses to terminate their lease agreement. A 30-day notice was not received by the facility from R1 until May 6, so costs incurred through June 4 would be the responsibility of R1 as specified under the lease agreement. Additionally, the complaint states that R1’s needs could not be met: requiring 24 hour care, and therefore, requiring care at another facility. LPA questioned staff S1 if 24-hour staff was available to meet the needs of R1. S1 stated the facility was not contacted by R1 notifying facility of change in condition or if facility was able to meet R1’s care needs. According to S1 facility does have 24-hour staffing able to meet the needs of R1, so the 30-day notice to terminate the lease agreement was still required. Therefore, the allegation that Facility charged resident for services not rendered is Unsubstantiated.

Although the allegations may have happened there is not a preponderance of evidence to substantiate the allegations therefore the allegations are unsubstantiated.

SUPERVISOR'S NAME: Kimberley Mota	TELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Jill Nakagawa	TELEPHONE: 707-588-5063
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025

LIC9099 (FAS) - (06/04)

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