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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 05/07/2025
Date Signed: 05/07/2025 11:07:53 AM

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
11/27/2024 and conducted by Evaluator Sabel Martinez
COMPLAINT CONTROL NUMBER: 08-AS-20241127101919
FACILITY NAME:ATRIA COLLWOODFACILITY NUMBER:
374600890
ADMINISTRATOR:JULIA LOPEZFACILITY TYPE:
740
ADDRESS:5308 MONROE AVETELEPHONE:
(619) 286-3583
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:185CENSUS: 94DATE:
05/07/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maintenance Director Omar ZamudioTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Resident personal belongings were stolen from bedroom.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sabel Martinez conducted an unannounced visit to conclude a complaint investigation. LPA was greeted by Maintenance Director Omar Zamudio, to whom the LPA dislcosed the purpose of the visit

The Department's investigation included facility, resident, and outside source records reviews, and resident and staff interviews.

On November 27, 2024, the Department received a complaint that alleged Resident1 (R1) had a theft of their personal belongings from their room on the morning of that same day. An interview with R1 reported there were two bonds in the amount of $50 dollars missing from their room. Law enforcement came to the facility to take a report. ED Lopez also reported the responding officer did not take a police report because there was no evidence to support the allegation.

[Continued on LIC9099C]
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
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-20241127101919
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: 05/07/2025
NARRATIVE
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[Continuation of LIC9099]

During the interview with R1 they reported the ED misinformed the responding officer by stating since R1 was independent staff do not have access to their room, however R1 revealed caregivers, and housekeeping entered their room each week. A review of R1’s care plan dated October 2, 2024, corroborated R1 was independent and did not require care, however the facility's basic plan included standard laundry and housekeeping services that were provided each week.

In addition, it was disclosed the ED informed the responding officer that this was the first theft allegation made against the facility however a facility file review revealed an additional complaint was filed regarding the theft of another resident’s property on June 23, 2023, and on June 21, 2023, a complaint was filed that alleged a staff member was found digging through a resident’s belongings.

A review of facility records revealed, per the facility's Admission Agreement and Health and Safety Code, the facility shall maintain a log (for 12 months) of all reported theft over $25.00 be maintained at the facility however the facility did not produce the record for the Department. Additionally, interviews conducted with facility staff and residents revealed no concerns of theft at the facility nor experienced any of their property stolen while residing at the facility. One Resident interview revealed they heard that another resident had money stolen at the facility but could not recall the Resident's name and believed they were no longer living there.

Based on interviews ad records reviews the allegation was determined to be Unsubstantiated. An Unsubstantiated finding means, although the allegation may be valid there was not a preponderance of evidence to prove the violation had occurred.

An exit interview was conducted with Zamudio, to whom a copy of this report, and Licensee/Appeals Rights (LIC 9058), were provided. Signature below confirms receipt of the reports.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Sabel Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2