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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 577000881
Report Date: 03/16/2021
Date Signed: 03/17/2021 10:38:48 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2020 and conducted by Evaluator Katrina Walters
PUBLIC
COMPLAINT CONTROL NUMBER: 21-AS-20201028143218
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:210CENSUS: DATE:
03/16/2021
UNANNOUNCEDTIME BEGAN:
04:07 PM
MET WITH:Ashlee SloanTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff are not trained properly
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Katrina Walters spoke with Administrator, Ashlee Sloan via Televisit to deliver findings regarding the above mentioned complaint allegation. Visit was done remotely due to Covid-19 precautions.

LPA Walters reviewed training records for staff, training material, conducted interviews and conducted an additional complaint visit on 11/03/2020. The complaint alleges that facility failed to train staff resulting in staff improperly lifting and transferring residents. LPA reviewed 5 Staff training records. Trainging records indicate that staff are given training upon onboarding. Annual transfer training is not conducted for transfers. Per Administrator transfer training for staff is conducted as needed. Staff interviews indicate that staff have received training and were knowledgable on how to conduct transfers.

Continued on 9099 C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Katrina WaltersTELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2021
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-20201028143218
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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 GARDENS
FACILITY NUMBER: 577000881
VISIT DATE: 03/16/2021
NARRATIVE
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Training records were consistent with the facility Program Plan provided to CCL upon licensure.

A finding that the complaint allegation- Staff are not trained properly has been unsubstantiated meaning that although the allegation may have happened there is not a preponderance of evidence to prove that the allegation occurred. We have therefore dismissed the complaint.
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5059
LICENSING EVALUATOR NAME: Katrina WaltersTELEPHONE: (707) 588-5057
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2