<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577000881
Report Date: 10/19/2020
Date Signed: 10/20/2020 11:39:00 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
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 GARDENSFACILITY NUMBER:
577000881
ADMINISTRATOR:ASHLEE SLOANFACILITY TYPE:
740
ADDRESS:1111 ALVARADO AVETELEPHONE:
(530) 756-0700
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY:0CENSUS: DATE:
10/19/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Ashlee SloanTIME COMPLETED:
06:15 PM
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
Licensing Program Analyst LPA Walters made contact with Resident Services Director, Yelena Shvets on this date by phone at approximately 3:00 PM for the purpose conducting case management visit. Executive Director, Ashlee Sloan, was available later. This visit is being done by phone due to COIVD-19 precautions. The reader is advised that this visit was not in-person. The purpose of this visit is to follow-up on a concern received regarding this facilities policy for residents to leave the facility and their visitation policy. LPA previously requested that the facility ED submit the facilities policy on residents who are being quarantined. LPA requested that the ED includes how residents are to exit the facility. Administrator sent policy but did not include how residents are to exit the facility. LPA requested that Administrator includes this on 8/31/2020, 9/15/2020 and 10/6/2020. LPA is conducting a tele-visit to review the facilities policy on residents leaving the facility.

LPA interviewed staff and Administrator. LPA toured the facility observed stairways exit signs, and elevators. LPA spoke with Executive Director, Ashlee Sloan. LPA is requesting the facility submits this plan in writing no later than 10/27/2020, Attention to LPA Katrina Walters. This is LPA's fourth and final request for the following: A specific plan that includes how ambulatory and non-ambulatory residents are to exit the facility.
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Katrina WaltersTELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1