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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374600890
Report Date: 07/23/2025
Date Signed: 07/23/2025 10:47:56 PM

Substantiated


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
12/19/2023 and conducted by Evaluator Debbie Correia
COMPLAINT CONTROL NUMBER: 08-AS-20231219090838
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: 98DATE:
07/23/2025
UNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Executive Director (ED) Julia LopezTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Facility did not notify residents of planned power outage.
Facility did not ensure adequate emergency lighting.
Facility did not ensure a comfortable temperature for residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Debbie Correia conducted an unannounced visit to deliver investigative findings on the above complaint allegations. LPA Correia was greeted by front lobby Receptionist Muhammad Wright, identified herself, and discussed the purpose of the visit. LPA then met with Executive Director (ED) Julia Lopez to whom was explained the purpose for the visit.

The Department’s investigation included staff, resident, Outside Source interviews, and a review of Outside Source records.

It was alleged staff did not ensure a safe environment during a 7-hour power outage on December 18, 2023. On December 19, 2023, the Department received a complaint regarding a planned power outage that the facility did not prepare for. An interview conducted with the Executive Director (ED) revealed they believed power outage was not planned and did not have prior knowledge of the outage.

[Continued on LIC9099C]
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
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 4
Control Number 08-AS-20231219090838
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: 07/23/2025
NARRATIVE
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[Continuation of LIC9099]

An interview conducted with Staff1 (S1) reported on December 18, 2023, when leaving their shift at approximately 10:00PM, saw the street in front of the facility had been blocked off. S1 stated they walked back into the facility and observed the facility lights were off and all power was shut down.

S1 stayed to assist the two (2) other care staff (S2 and S3) until 6:00 AM the following morning. S1 also disclosed they, along with S2 and S3, checked on the residents with flashlights every 2 hours, and the Director of Maintenance (DOM) came to the facility for approximately 1.5 hours. An interview conducted with the DOM corroborated they came to the facility to confirm the generators that provided electricity to the facility kitchen and resident hallways were operational. DOM also revealed the generators did not provide power to the resident rooms.

An Outside Source interview and a review of secured Outside Source records confirmed the power outage was planned. Outside Source also confirmed a notification letter was sent to the corporate office on December 4, 2023, and an Outside Source interview revealed an additional 2 automated notification calls were sent a week prior and the day of the power outage. [See LIC 811 for Confidential Names]

Based on evidence obtained, the allegation is substantiated because the preponderance of the evidence standard has been met. Deficiency is being cited in accordance with the California Code of Regulations, Title 22, Division 6 Chapter 8, and listed on the attached 9099D.

An exit interview was conducted with ED Lopez. ED Lopez was informed a copy of this report along with the Licensee Rights (LIC 9058 01/16) will be provided at the conclusion of the visit. Signature below confirms receipt of these rights.

SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 08-AS-20231219090838
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2025
Section Cited
CCR
87211(d)(5)
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Reporting Requirements (d) The Licensee shall notify… all residents… in writing within two business days of…the following… (5) A utility company has sent a notice of intent to terminate electricity… within…15 days….

This requirement was not met as evidenced by:
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ED Lopez agreed to call Corporate office to ensure utility ageency notifications are brought to the communities attention.

ED will provide CCL with written documentation of Corporate communication with all utility agencies regarding notification of any disturbance in service by the POC due date.
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Based on a resident and staff interviews the facility did not provide advanced written notice of a planned power outage in December to R1.

This posed a potential Health and Safety, and Personal Rights risk to [R1], 1:91 residents in care.
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Type B
06/23/2025
Section Cited
CCR
87303)(h)
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Maintenance and Operation (h) Emergency lighting shall be maintained. ...this shall include flashlights, or other battery powered lighting, readily available in appropriate areas accessible to residents and staff.

This requirement was not met as evidenced by:
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ED Lopez will ensure an emergency supply is easily accessible to staff to ensure adequate lighting for residents in care throughput the facility.

LPA observed and secured photos of the current supply of readily available battery powered lighting for residents in care. Deficiency is cleared.
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Based on a resident and staff interviews the facility did not provide readily available emergency lighting or heat to R1's room.

This posed a potential safety risk to [R1], 1:91 care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 08-AS-20231219090838
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2025
Section Cited
CCR
87303(b)(1)
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Maintenance and Operation (b) A comfortable temperature for residents shall be maintained at all times.(1) The facility shall heat rooms that residents occupy to a minimum of 68 degree F, (20 degrees C).

This requirement was not met as evidenced by:
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ED will ensure an extra supply of blankers are available to residents in care in the case of a power outage or any malfunction of an HVAC unit.

LPA observed and secured photos of the current supply of readily available blankets for residents in care. Deficiency is cleared.
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Based on a resident and staff interviews the facility did not provide alternative forms of heat during a power outage to R1's room.

This posed a potential Personal Rights risk to [R1], 1:91 residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Debbie Correia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4