374600890-4-30-2025-08-AS-LTEZ-DG99KL-20250430232632

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 04/30/2025
Date Signed: 04/30/2025 12:24:41 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/13/2024 and conducted by Evaluator Sabel Martinez

COMPLAINT CONTROL NUMBER: 08-AS-20240313085040

FACILITY NAME:	ATRIA COLLWOOD		FACILITY NUMBER:	374600890
ADMINISTRATOR:	JULIA LOPEZ		FACILITY TYPE:	740
ADDRESS:	5308 MONROE AVE		TELEPHONE:	(619) 286-3583
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92115
CAPACITY:	185	CENSUS: 97	DATE:	04/30/2025
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Executive Director Julia Lopez		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not respond to resident's calls for assistance.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced follow up complaint investigation visit and delivered complaint findings. The LPA introduced himself and disclosed the purpose of the visit to Executive Director Julia Lopez.

Throughout the investigation, the Department secured records and conducted interviews with external and internal sources, including staff and residents.

It was alleged staff did not respond to a resident's call for assistance. On March 13, 2024, it was reported to the Department staff did not respond to Resident # 1’s (R1) call for assistance with retrieving medication from under R1’s bed. It was reported R1 called the front desk, but the front desk did not answer the phone.

(See LIC 9099-C for continuation of report.)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025

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 08-AS-20240313085040

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: ATRIA COLLWOOD	FACILITY NUMBER: 374600890
	VISIT DATE: 04/30/2025

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

Interviews with staff and residents revealed the facility’s front desk phone line was transferred to a cordless phone after 7pm. The cordless phone was them answered by the medication technician on duty. Some interviews revealed there were occasions when the phone malfunctioned and calls would not go through, but this was addressed promptly. Residents were advised to use the call pendant for emergencies, falls, and incontinence care. Residents were encouraged to call the front desk for any other services required.

Interviews with staff and residents revealed residents were still able to press the call pendants when the front desk phone line was not operating properly. Residents did not report any concerns with lack of medication assistance, nor concerns with staff not responding to pendant calls. Residents did not recall being discouraged from using the pendants to summon staff for assistance. An interview with R1 confirmed R1 was not part of the facility’s medication management program. R1 confirmed R1 had additional dosages of the medication in question, and R1 did not miss a scheduled dose. R1 confirmed housekeeping staff retrieved R1’s medication on a subsequent day.

Although some interviews revealed conflicting statements on if residents were encouraged, or discouraged to use the call pendants; the interviewed residents did not have any concerns with staff not responding to pendant calls for assistance. Therefore, the allegation was unsubstantiated.

An exit interview was conducted with Lopez, to whom a copy of this report, LIC 811 Confidential names list, and Licensee/Appeals Rights (LIC 9058), were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/30/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2