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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 075600352
Report Date: 04/01/2025
Date Signed: 04/14/2026 01:51:52 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/28/2025 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 15-AS-20250328093839
FACILITY NAME:ATRIA WALNUT CREEKFACILITY NUMBER:
075600352
ADMINISTRATOR:KELLI GREENEFACILITY TYPE:
740
ADDRESS:1400 MONTEGOTELEPHONE:
(925) 938-6611
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:200CENSUS: 157DATE:
04/01/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Executive Director Kelli GreeneTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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9
Staff did not ensure resident's a/c was not in disrepair.
INVESTIGATION FINDINGS:
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*****Amended Report from 04/01/2025 Delivered on 04/14/2026*****
On 04/01/2025, at 1:00 PM, Licensing Program Analyst (LPA) James Sampair arrived unannounced to investigate the allegations above. Upon arrival, the LPA informed Executive Director (ED) Kelli Greene of the purpose of the visit.

The complaint alleges staff did not ensure resident's a/c was not in disrepair.
The LPA interviewed Witness W1 by telephone. The LPA interviewed the ED and Maintenance Director James Campers about the operation of the Heating, Ventilation, and Air Conditioning (HVAC) system. The system is fully operational. The data collected from the interviews shows that the staff are acting to ensure that it is not in disrepair, which does not confirm the allegation.

Continued on LIC 9099-C . . .
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
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 15-AS-20250328093839
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME: ATRIA WALNUT CREEK
FACILITY NUMBER: 075600352
VISIT DATE: 04/01/2025
NARRATIVE
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....Continued from LIC 9099

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove them; therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: James Sampair
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2