Atria Valley View

Type of visit: Case Management - Other

On 07/28/2023 at 9:00 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to personally deliver findings from complaint 15-AS-20230718113231 to resident R1. LPA stated the purpose of the visit to the front desk person without identifying the identity of R1. During the visit, the LPA spoke with the initial complainant about the findings. The questions she asked prompted some questions for the LPA to follow up on. For that reason, the LPA interviewed Resident Services Director (RSD) Joann Bustos about the level of care being provided to resident R1. The RSD verified that the services being provided matched those on R1's Plan of Care. LPA then reported back to the Complainant verification that R1 was fully receiving the level of care as written in her Plan of Care. No citations issued during this visit. Exit interview was conducted with ADM. A copy of this report was provided via email.the state’s words, verbatim · CDSS document, Jul 28, 2023

Allegation investigated: Staff does not assist resident when needed. Staff disturbs resident’s sleep. Staff does not treat resident with respect. Resident’s toilet is in disrepair. Staff does not empty resident’s trash receptacles.

On 07/26/2023 at 2:30 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to continue the complaint investigation of the allegations above. LPA informed Administrator (ADM) Kawana Anthony of the reason for the visit. During the investigation, the LPA interviewed 3 residents, complainant, the ADM, and reviewed facility and resident records. Listed below are the allegations and a brief explanation of the evidence upon which the finding was based: Staff does not assist resident when needed. Based on LPA observations, record reviews, an interview with R1, interviews with 2 other residents receiving the same level of care, and the ADM, the LPA found that the staff members are providing assistance to R1 at a level that surpasses that for which she pays. (Continued on LIC9099-C...) Unsubstantiated (...Continued from LIC9099) Staff disturbs resident’s sleep. Based on LPA observations, record reviews, an interview with R1, and the ADM, the LPA found that the staff members are providing assistance in accordance with the scheduled times in her plan of care. Staff does not treat resident with respect. Based on LPA interview with R1, LPA's observations of staff interactions with other residents, interviews with 2 other residents receiving the same level of care, and the ADM, the LPA found that there was no evidence to support that staff members are intentionally treating the resident disrespectfully. Resident’s toilet is in disrepair. Based on LPA observation of the toilet, it is fully functional. Staff does not empty resident’s trash receptacles. Based on LPA observations, record reviews, an interview with R1, and the ADM, the LPA found that the staff members empty the resident's trash receptacles for R1 at a level that surpasses that for which she pays. Although the allegations may have happened, or are valid, there is not a preponderance of evidence to prove them; therefore, the allegations are UNSUBSTANTIATED. Exit interview was conducted with ADM. A copy of this report was provided via email.the state’s words, verbatim · CDSS document, Jul 26, 2023 · control 15-AS-20230718113231

Type of visit: Required - 1 Year

On 06/27/2023 at 09:45 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an Annual Inspection. Upon entry, LPA stated the purpose of the visit to front desk staff members. At approximately 10:15 AM, LPA met with Administrator (ADM) Kawana Anthony. During the inspection, LPA reviewed files of 5 residents and 5 staff, toured the facility inside and outside, and interviewed 4 residents and 4 staff members. During this inspection, no citations were issued. Exit interview conducted with ADM and a copy of this report was provided via email.the state’s words, verbatim · CDSS document, Jun 27, 2023

Allegation investigated: Staff did not assist resident with showering as needed. Staff did not assist resident with dressing as needed. Staff did not provide appropriate food service for diabetic resident. Staff did not disinfect visibly soiled surfaces. Resident's air conditioning is in disrepair. Staff did not safeguard resident's valuables.

On 05/12/2023 at 1:15 PM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct an initial 10-day investigation regarding the above allegations. LPA explained the purpose of the visit to front desk staff and later with Interim Executive Director (IED) Kawana Anthony. LPA interviewed the Administrator, 3 residents, and conducted a review of resident and facility records. Staff did not assist resident with showering as needed. No evidence that Resident R1 was being provided additional assistance with showering at that time, so therefore, there was no evidence that those services had not been provided. Staff did not assist resident with dressing as needed. No evidence that Resident R1 was being provided additional assistance with dressing at that time, so therefore, there was no evidence that those services had not been provided. (Continued on LIC9099-C...) Unsubstantiated (...Continued from LIC9099) Staff did not provide appropriate food service for diabetic resident. Admissions agreement for residents does not include food service for diabetic residents. Instead, it is something residents must provide for themselves if/when the need arises. Staff did not disinfect visibly soiled surfaces. No evidence that Staff were not disinfecting visibly soiled surfaces. Resident's air conditioning is in disrepair. Resident's air conditioner was working and the room temperature was measured at 77 degrees F, which is within the safe range. Staff did not safeguard resident's valuables. No evidence that Residents' valuables were not being safeguarded. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did occur; therefore, the allegations are UNSUBSTANTIATED. Exit interview conducted and a copy of this report provided via email.the state’s words, verbatim · CDSS document, May 12, 2023 · control 15-AS-20230508150522

Type of visit: Case Management - Incident

On 05/02/2023 at 3:10 PM, Licensing Program Analyst (LPA) J Sampair arrived unannounced for a visit concerning the gastrointestinal outbreak at the facility with Interim Executive Director (IED) Kawana Anthony. At approximately 3:50 PM, Resident Services Director (RSD) Joanne Bustos joined the meeting and it was after her arrival when they addressed the Unusual Incident Report (UIR) concerning a resident-on-resident fight that was dated 02/08/2023. The RSD provided an update concerning Resident 1 (R1) who had been reported to have instigated the assault to Resident 2 (R2) as witnessed by Resident 3 (R3). The RSD reported that there had not been any additional incidents involving R1, and that he was scheduled to move out of the facility the following day. No citations issued during visit. Exit interview conducted with IED and a copy of this report provided via email.the state’s words, verbatim · CDSS document, May 2, 2023

Type of visit: Case Management - Health Checks

On 05/02/2023 at 3:15 PM, Licensing Program Analyst (LPA) J Sampair arrived unannounced for a visit concerning the gastrointestinal (GI) outbreak at the facility reported on 05/01/2023. Upon entry, LPA explained purpose of the visit to Interim Executive Director (IED) Kawana Anthony, National Operations Specialist for Atria Senior Living. IED Anthony provided information to LPA Sampair on the current status of the outbreak and the measures being taken at the facility to stop its spread and to care for residents. At that time, a total of 11 residents were ill with the Norovirus (2 of whom had been hospitalized and back at tacility). At approximately 3:50 PM, Resident Services Director (RSD) Joanne Bustos joined them to provide additional information. No new cases had been reported since noon, and unlike the GI outbreak reported in 02/28/2023 no staff members had been infected. The Department of Public Health has been notified. To help stop the spread of the infection, staff and residents are masking. They have stopped group dining and group activities. Residents are being served meals in their room. No citations issued during visit. Exit interview conducted with IED and a copy of this report provided via email.the state’s words, verbatim · CDSS document, May 2, 2023

Type of visit: Case Management - Incident

On 01/26/2023 at 10:15 AM, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a Case Management visit that concerned an Unusual Incident Report (UIR) that described an incident on 01/18/2023. The UIR concerned a supposed verbal threat made to resident R1 by R2 on 01/18/2023. R2 did not remember having had that exchange with R1 and there were no witnesses of it having occurred. Upon entry, LPA explained the purpose of the visit to Rosario Holandez, Community Business Director. Executive Director (ED) Kelli Greene arrived at approximately 10:45 AM. During the meeting, the LPA and ED reviewed both residents' records and what actions had been taken up to this time and the future actions to be taken to reduce the likelihood of additional conflicts between the residents. The LPA was satisfied that the facility was taking the appropriate measures. No citations were issued. Exit interview conducted and copy of this report provided via email.the state’s words, verbatim · CDSS document, Jan 26, 2023

Type of visit: Case Management - Incident

On 01/04/2023, Licensing Program Analyst (LPA) J. Sampair arrived unannounced to conduct a Case Management Inspection concerning an Unusual Incident Report (UIR) about a missed prescription for resident R1 on 12/30/2022. Upon entry, LPA explained the purpose of the visit and met with Rosario Holandez, Community Business Director. The LPA interviewed Staff Member S1 who was the staff member who had originally reported the incident. Based on what S1 reported, the facility had reacted quickly enough that the medication did arrive in time for R1 to take her medication on the day she was scheduled to receive it. No citations were issued. Exit interview conducted and copy of this report provided via email.the state’s words, verbatim · CDSS document, Jan 4, 2023

Type of visit: Required - 1 Year

On 07/25/22 at 1:30PM, Licensing Program Analyst (LPA) J. Sampair conducted an infection control annual inspection. Upon entry into facility, LPA explained the purpose of the visit. LPA met with and toured the facility with Executive Director Kelli Greene, Facility has an infection control plan in place that they are following. The designated infection control leader is the administrator. They have one central entry point that has been designated for universal entry screening with the station located near the front entrance with visitor's log, hand sanitizer, face masks, and no touch thermometer. Facility follows daily cleaning, sanitation of frequently touched common surfaces with disinfectants. COVID-19 signs were posted to promote hand washing, cough/sneeze etiquette and physical distancing. Administrator is on site a minimum of 20 hours a week to oversee proper business operation. No deficiencies cited during this visit. Exit interview conducted and a copy of this report provided via email.the state’s words, verbatim · CDSS document, Jul 25, 2022

Allegation investigated: Resident's are confined to their room. Adequate food service is not being provided to residents.

On 12/30/2021 at 8:40AM, Licensing Program Analyst (LPA) G. Luk arrived unannounced to deliver complaint findings for the allegations above. LPA met with Executive Director, Kelli Greene. During the investigation, LPA interviewed 4 residents, 6 staff, witness, and complainant. LPA obtained and reviewed resident roster, staff roster, facility menu, and communications sent to residents regarding COVID-19 procedures. On 3/5/2020, CCLD sent out PIN 20-04-ASC to licensee regarding guidance on COVID-19. The PIN's guidance was to minimize congregate living activities and ensure that residents are eating their meals in their rooms instead of in congregate settings. The facility sent out communication to residents and families in March 2020 which stated "we strongly encourage residents to stay in their apartments, only leave when necessary and practice social distancing when outside of their apartment." (Continue on LIC9099C...) Unsubstantiated On 3/27/2020, LPA conducted a video tour of the facility and observed notices posted reminding residents to stay in their apartments. Interview with residents revealed that residents understood why they had to stay in their apartments during the pandemic. Residents stated that they can leave the apartment if needed. Interview with residents revealed that food service was fine during the beginning of the pandemic (March 2020). Residents did not have issues receiving their meals during the pandemic. Residents have microwaves in their apartment to warm the meals if needed. Interview with staff revealed that meals were kept in a large bag to keep the food hot during delivery. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did occur, therefore these allegations are UNSUBSTANTIATED. Exit interview conducted. A copy of this report provided.the state’s words, verbatim · CDSS document, Dec 30, 2021 · control 15-AS-20200320104605

Allegation investigated: Staff spoke inappropriately to resident Facility did not report suspected abuse in a timely manner

On 10/22/21 at 3PM, Licensing Program Analyst (LPA) Daisy Panlilio conducted an unannounced complaint investigation and met with Community Business Director (CBD). LPA explained the purpose of the visit with CBD and Executive Director (ED) on the phone. ED authorized CBD to act on her behalf and sign the reports. Allegation: Staff spoke inappropriately to resident Investigation Finding: Substantiated During investigation, ED confirmed with LPA that S1 admitted to saying "shut your mouth" to resident (R1) when R1 was sharing personal information about another resident with someone else the weekend of 09/11/21 - 09/12/21. Internal investigation conducted by ED confirmed S1 verbally abused R1 at the facility. Continued on next page, LIC 9099-C Substantiated Allegation: Facility did not report suspected abuse in a timely manner Investigation Finding: Substantiated Based on interviews and record reviews, R1 reported the incident to the ombudsman on 09/13/21. On 09/21/21, LPA C Fowler received a faxed SOC341 report from ED stating that the Ombudsman asked the ED to complete an SOC341 while the ED was still in the process of completing the investigation of the incident. LPA confirmed with ED that facility failed to report the suspected elder abuse in a timely manner. ED also told LPA that unusual incident report (LIC 624) was not completed/sent to CCLD regarding the incident. Deficiencies are cited per Title 22 California Code of Regulations and listed on LIC9099D. Failure to submit proof of correction (POC) by plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Oct 22, 2021 · control 15-AS-20211013102820

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87468.1(a)(1) · Plan of correction due date: Nov 8, 2021

(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:(1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by S1 admitting to verbally abusing R1 which posed a potential health & safety risk to residents in carethe state’s words, verbatim · CDSS document, Oct 22, 2021

Plan of correction: ED discussed the incident with S1, conducted in-service retraining on 09/23/21 regarding elder abuse. ED agreed to submit to CCLD on or before POC due date staff retraining certification from an accredited vendor on elder abuse.

From the deficiency page — Deficiency type: Type B · Section cited: CCR 87211(b) · Plan of correction due date: Nov 8, 2021

Any suspected physical abuse that results in serious bodily injury of an elder or dependent adult shall be reported to the local ombudsman, the corresponding licensing agency, and the local law enforcement agency within two (2) hours as required by Welfare and Institutions Code Section 15630(b)(1) This requirement was not met as evidenced by SOC 341 not reported in a timely manner which posed a potential health & safety risk to residents in carethe state’s words, verbatim · CDSS document, Oct 22, 2021

Plan of correction: ED agreed to submit to CCLD on or before POC due date a self certification that staff will comply with Title 22 Section 87211 reporting requirements regulations.

Allegation investigated: Resident was provided services without Resident Representative's approval. Resident Representative was not allowed to participate in the planning of resident's care. Staff did not provided a copy of the care plan to Resident's Representative.

On 8/17/2021 at 09:35AM, Licensing Program Analyst (LPA) L. Hall arrived unannounced to deliver complaint findings for the above allegations. LPA met with Kelli Greene, Executive Director, and explained the reason for the visit. During the course of investigation, LPA interviewed staff, witnesses, obtained and reviewed staff roster, residents' roster, and resident's file including physician's reports, functional needs assessment, and incident reports. Interviews with witnesses and staff indicated that R1 could make her own decisions and that R1 contacted the agency for a private care person. Documentation indicated that the functional needs assessment was emailed twice to W1. Continued on LIC9099C. Unfounded Continued from LIC9099. This agency has investigated the complaint on the above allegations, we have found that the complaint was UNFOUNDED, meaning that the allegations was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint. Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 17, 2021 · control 15-AS-20210622140830