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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800366
Report Date: 10/15/2024
Date Signed: 10/15/2024 03:41:14 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2023 and conducted by Evaluator Kelly Dulek
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20231115151656
FACILITY NAME:ATRIA HILLCRESTFACILITY NUMBER:
565800366
ADMINISTRATOR:ADAM SYNCHEFFFACILITY TYPE:
740
ADDRESS:405 HODENCAMP RDTELEPHONE:
(805) 373-0606
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:207CENSUS: 125DATE:
10/15/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Remon PagelsTIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff left resident in soiled clothing and diapers for a period of time.
Staff not keeping resident’s room free from odor.
Staff does not maintain residents hygiene.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct subsequent complaint visit to address the allegations listed above. LPA met with Executive Director/Administrator (ED) Remon Pagels upon arrival. Entrance interview conducted.

During today's visit, LPA toured the facility with ED at 11:31AM, interviewed staff and residents from 12:02PM to 02:34PM. Additionally, LPA observed residents throughout the visit. During an initial complaint visit, conducted by LPA Elsie Campos on 11/21/2023, LPA Campos collected pertinent documents relevant to the investigation and conducted a physical plant tour with Memory Care Director of resident rooms in Memory Care at 12:05PM and conducted resident observations at 12:30PM. Throughout the investigation, LPA Dulek reviewed all documents. The following was then determined:

Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
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 29-AS-20231115151656
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ATRIA HILLCREST
FACILITY NUMBER: 565800366
VISIT DATE: 10/15/2024
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
26
27
28
29
30
31
32
Allegation "Staff left resident in soiled clothing and diapers for a period of time:"
The complaint alleges that Resident #1 (R1) who resides in the facility's Memory Care unit, is not being provided clean clothing daily and that the resident is being left in soiled incontinence briefs. During both the initial and subsequent complaint visit, both LPAs observed residents to be wearing clean clothing, and with no obvious signs of soiled incontinence briefs. Residents interviewed indicated the staff are nice and they are assisted with toileting and changing clothes daily. Staff interviews revealed that residents are provided incontinence care at least every 2 hours or more frequently as needed. Memory Care staff do launder residents' clothing and bedding at a minimum weekly, or more often if needed. Staff interviewed stated that in Memory Care there are 2 care levels and residents are assessed to ensure their care needs are being met. Staff do carry ipods that track the care needs of the residents and as tasks are completed for a resident, staff indicate completion on the ipod. Staff interviewed denied the allegation, stating they have never seen residents left in soiled clothing and/or diapers. Based on interview and observation, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation "staff left resident in soiled clothing and diapers for a period of time" is deemed UNSUBSTANTIATED at this time.

Allegation "Staff not keeping resident room free from odor:"
The complaint alleges that R1's room smells of urine and is not cleaned adequately to meet the needs of the resident. Both LPAs during the initial and subsequent complaint visit, observed resident rooms for incontinence odors, including R1's room. No odors were observed in Memory Care during either visit. Additionally, LPA reviewed copies of carpet cleaning invoices and work orders from the period of time the complaint was received. Record review revealed that R1's room and the hallway R1's room is located in did have the carpets cleaned regularly. Staff interviewed indicate if they notice an odor from a resident's room, they will immediately report to maintenance staff to ensure the room is cleaned as soon as possible. Staff also stated that following incontinence care, staff remove all soiled items from a resident's room to ensure odors are kept to a minimum. Based on observation and interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore the allegation "staff not keeping resident room free from odor" is deemed UNSUBSTANTIATED at this time.

Report Continued on LIC 9099-C
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20231115151656
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ATRIA HILLCREST
FACILITY NUMBER: 565800366
VISIT DATE: 10/15/2024
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
26
27
28
29
30
31
32
Allegation "Staff does not maintain residents hygiene:"
The complaint alleges that R1's hygiene is not up kept, however no additional information was provided. During both the initial and subsequent complaints, LPAs observed residents to be clean, properly groomed and no concerns with hygiene were noted. Staff interviewed indicated that some residents do refuse hygiene care occasionally, but that this is documented and communicated with residents' physician and family. Most residents are compliant in meeting hygiene needs with staff assistance. R1 was observed in both the initial and subsequent complaint visits to be properly groomed and clean. Residents interviewed stated they are independent with their hygiene needs, but that the care staff are wonderful and make sure they are taken care of. Staff interviews revealed that there are daily tasks assigned to each caregiver for each resident they are responsible for. Staff stated there are enough staff present to meet resident needs and if a resident has an unmet need or refuse care with a particular caregiver, they ask each other for assistance and usually a change of care staff will encourage residents to allow care to be provided. Based on observation and interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation "staff does not maintain residents hygiene" is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today's report was provided.
SUPERVISOR'S NAME: Kristin HeffernanTELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly DulekTELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3