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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 02:06:51 PM

Substantiated


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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Staff did not ensure resident's room was free of bed bugs.
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 room was free of bed bugs.
On 04/01/2025, the LPA interviewed Witness W1 by telephone, who stated that she had informed the ED two months earlier of the bed bug infestation in Resident R1’s room. On 04/01/2025, the LPA interviewed the ED and Regional Vice President (RVP) Natasha Georges in person. The ED and RVP stated that no bed bugs were found in R1’s room during the weekly bed bug checks conducted by housekeepers who inspect only beds. R1 does not sleep on her bed, she sleeps on her recliner so they missed the bed bugs there. On 04/01/2025, the LPA reviewed the 03/27/2025 Ecolab report for R1’s room that stated there was a “heavy infestation” of bed bugs in the room. The data collected supports the allegation.

Continued on LIC 9099-C . . .
Substantiated
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 3
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

Based on the information obtained by the LPA during the investigation, the preponderance of evidence standard has been met; therefore, the allegation above is SUBSTANTIATED.

Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC 9099-D. Failure to submit Proof of Corrections (POCs) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

Exit interview conducted and a copy of this report 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 3
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/02/2025
Section Cited
CCR
87307(d)(2)
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87307 Personal Accommodations and Services (d) The following ... shall apply to all facilities: (2) The premises shall ... provide a safe and healthful environment.

This requirement is not met as evidenced by:
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Facility cleared during inspection.
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Based on record review of Ecolab report dated 03/27/2025 that states, "Bed bugs noted during inspection. Live activity found in room 326. Heavy infestation.", which poses an immediate health risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
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 appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3