Atria Covina

***This report supersedes the report delivered on 12/12/2025. The reason for the amendment is to remove confidential information listed on the initial report. The findings will remain unsubstantiated. *** Licensing Program Analyst (LPA) Vaid conducted a subsequential visit to deliver the findings for the above-mentioned allegations. Met with Crystene Char, toured the facility and did not observe any health and safety concerns. On 5/6/25, Licensing Program Analyst (LPA) S Vaid conducted an initial 10-day complaint investigation visit for the above allegations. LPA met with Irina Sarkisyan, Community Business Director, Crystene Char, Administrator was notified, Administrator arrived shortly after, and complaint was discussed. LPA Vaid and Administrator Char did not observe any safety concerns during the facility tour. The investigation consisted of the following: LPA toured the physical plant. LPA Interviewed staff 1-7 (S1-S7), and residents #2-#8 (R2-R8) resident R1 is currently in skilRead the full finding— CDSS inspection report, December 12, 2025 · control 28-AS-20250501163701

Licensing Program Analyst (LPA) Tao conducted an unannounced complaint investigation for the allegations listed above today. During today’s visit, LPA met with Alondra Fuentes, administrator upon arrival. LPA explained the purpose of today's visit to staff. Investigation consisted of the following: interviews of staff from Staff #1 (S1) through Staff #4 (S4); interviews of residents from resident#1 (R1) through resident #7 (R7); reviewed resident#1’s record reviews, and a facility tour. LPA obtained copies of the staff and resident rosters, resident#1’s files and documents with relevant information. In regard of the allegation, “staff abused resident while in care,” it was alleged that resident#1 (R1) was abused by staff since resident had not paid rent for months. (-continued in LIC 9099 C-) UnsubstantiatedRead the full finding— CDSS inspection report, July 14, 2023 · control 28-AS-20230705160321

Licensing Program Analyst (LPA) Glenn Trueman made an unannounced visit to the facility and was greeted by Administrator Alondra Fuentes and explained the reason for the visit. The purpose of the visit is to investigate the above allegation. At today's visit Resident and Staff Roster were submitted. Special Incident Reports (SIR's) were submitted. File was reviewed for Resident R 1 and Physician's Report and Emergency ID page were submitted. Interviews were conducted with Administrator and Director of Culinary Services from 1:30 PM to 2:00 PM. Tour of the dining room and kitchen was conducted at 2:00 PM. Interviews were conducted with Residents R 1- R 7 from 2:05 PM to 2:40 PM. In regards to the allegation Staff failed to provide adequate food service, based on interviews conducted and information gathered Resident's 2-7 all stated that they always get there 3 meals a day and have never missed a meal. Also stated they have never heard of any resident's missing a meal. UnsubstantiatedRead the full finding— CDSS inspection report, June 22, 2023 · control 28-AS-20230616134125

***This report serves as an amendment and supersedes the original complaint investigation report created on 06/09/21. The purpose of this amended Licensing report is to provide clarification of the original complaint. The findings remain substantiated. *** On 06/09/21, Licensing Program Analyst (LPA) Tao conducted an unannounced initial 10 days complaint investigation and addressed the above allegations. LPA met with the previous Administrator, Subashsani Kumar. Today 09/29/22, Licensing Program Analyst (LPA) Tao conducted a subsequent complaint investigation visit and addressed the above allegations to the current administrator, Alondra Fuentes. The investigation consisted of the following: LPA interviewed staff from staff #1 (S1) to staff#6 (S6) and interviews residents from resident #1 (R1) to resident #5 (R5). LPA reviewed and obtained resident#6 (R6)’s incident report, R6’s death report, R6’s facility files, staff’s in-service-training log, cleaning log, resident roster and staffRead the full finding— CDSS inspection report, September 29, 2022 · control 28-AS-20210604121329

On 04/28/22, Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced complaint visit at the above noted facility. LPA Randle met with Resident Service Director Mildred Pascual. LPA Randle explained the purpose of the visit is to deliver findings for the allegation mentioned in the complaint. The investigation consisted of the following: This complaint was initially assigned to LPA Bonnie Tao. On 12/28/2021, LPA Bonnie Tao conducted the initial visit which consisted of interviews of Staff 1 to staff 3 and interviews of residents 2 to 6. A physical plant tour of the facility and R1’s room were conducted. R1 file review was conducted. LPA obtained a copy of resident roster, staff roster, R1's Identification and Emergency, R1’s Admission Agreement, R1’s Resident Account Summary, R1's Remittance (billing record), email printout from Staff#2 regarding credit to Jan 2022 rent. On 4/8/2022, the complaint was reassigned to LPA Jeremiah Randle. On 4/25/2022 Licensing Program AnaRead the full finding— CDSS inspection report, April 28, 2022 · control 28-AS-20211223104003

On 04/28/22, Licensing Program Analyst (LPA) Jeremiah Randle conducted an unannounced complaint visit at the above noted facility. LPA Randle met with Resident Service Director Mildred Pascual. LPA Randle explained the purpose of the visit is to deliver findings for the allegation mentioned in the complaint. The investigation consisted of the following: Licensing Program Analyst (LPA) Tao initiated a complaint investigation for the allegations listed above on 8/24/2020. LPA Tao spoke with Administrator SUBASHSANI KUMAR, (S1) on 8/31/2020 and conducted interview. The LPA obtained copies of staff roster, resident roster, Resident #1 (R1)’s progress notes, R1’s physician report, R1’s 30-day Notice to Quit, dated 8/13/2020, and R1’s incident reports, dated 08/13/2020 and 08/24/2020. LPA Tao requested S1 to provide copies of R1’s Identification and Emergency contact information, R1’s Preplacement Appraisal, R1’s Resident Appraisal, R1’s Need and service plan, R1’s Conservatorship documents,Read the full finding— CDSS inspection report, April 28, 2022 · control 28-AS-20200824103452