Atria del Sol

if not in the common areas. Six out of six staff state grooming and hygiene needs were being met although the resident would frequently refuse grooming as well as incontinence care. Facility staffing in memory care is as follows: Three caregivers/ med tech for 1st and 2nd shift depending on census and 1 caregiver/ med tech for NOC shift. The resident had a cat and six out of six staff state caring for the cat as well as cleaning the cat box. Due to the propensity of the cat to vomit and incontinence needs, carpet cleaning was conducted 1-2 times per week at a minimum and Maintenance confirms this service. Review of housekeeping records show the resident's room was being regularly cleaned. LPA observed no odors in the facility on three different visits. Physician order dated 02/05/2025 indicates resident was prescribed Seroquel 25mg the evening of 02/05/2025. Medication administration record shows the facility was waiting for the prescription to be filled prior to the resident being hospitalized for a urinary tract infection on 02/09/2025. Facility staff indicate insurance issues and a change in protocol of the pharmacy may have resulted in the delay in filling the prescription. Staff indicate an incident where the resident's family member was inadvertently told the resident had received the medication when in fact the medication was not on-site yet. LPA reviewed two physician orders for Tylenol and Ativan as routine medications following Atria's policy of no PRN medications in the memory care unit. Both were signed by R1's personal physician. Based on observations and interviews conducted, LPA is unable to corroborate the allegations. Therefore, the allegations are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with Administrator and a copy of this report was provided to facility.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on an incident report dated 11/30/2025. LPA was greeted and granted entry into the facility and explained the reason for the visit. Incident report dated 11/30/2025 indicated Resident 1 (R1) was walking down the hallway and fell. Maintenance Tech found the resident unresponsive at 10:45 AM and 911 was called. Resident was pronounced deceased at 11:00 AM at the facility. Physician report dated 02/06/2025 shows resident is diagnosed with Dementia. Facility notes indicate resident has had multiple falls in the facility. Facility to provide a copy of the death certificate upon receipt. LPA observed no health or safety concerns during today's visit. Exit interview conducted and a copy of this report was left at the facility. *This is an amended report to reflect a change in verbiage.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit to Atria Del Sol. The purpose of today’s visit was to conduct the Annual Required inspection. LPA was allowed entry into the facility and explained the reason for the visit. Facility is licensed for 64 ambulatory and 51 non-ambulatory of which 5 may be bedridden. Facility has an approved hospice waiver for 11 residents and the facility currently has 5 residents on hospice care. Jeremiah Goodwin has an administrator certificate expiring on 07/28/2025. LPA Lyman along with Administrator Goodwin toured the facility at 11:05 AM. LPA toured the physical plant, checked food service, facility records and the first aid kit. Facility appears to be clean, safe, and sanitary. Facility consists of three stories housing 63 apartments in assisted living, 27 apartments in memory care, multiple outside areas, two dining rooms, beauty salon, fitness area, movie theater, bistro and two activity areas. Resident apartments had the required furniture, bed linens and closet/drawer space to accommodate each resident comfortably. Resident restrooms were checked. Toilets and water faucets worked properly, grab bars were secure and shower was free of mold/mildew. Water temperature measured between 108.5 and 113.1 degrees F in facility restrooms. Resident bath towels, toiletries and personal hygiene supplies were adequately stocked at time of visit. Staff responded within 5 minutes for emergency pull. Common areas were clean and clear of hazards, doorways were free of obstructions. First aid kit had all the required elements including tweezers, thermometer, and scissors as well as a first aid manual. LPA observed cleaning supplies are secured. Kitchen was inspected. Perishable and non-perishable food supply was checked and adequately stocked at time of visit. Facility is keeping a log of freezer/ refrigerator temperatures and all were in range. Smoke detectors and fire inspections are conducted annually by an outside company, Systems Specialist, with the last inspection date in December 2024. CONTINUED ON LIC 809C DATED 05/13/2025 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 Facility has carbon monoxide detectors in facility hallways and were tested to be operational. Fire extinguishers are fully charged. LPA observed evacuation chairs at stairwells. LPA toured the outside grounds and there is ample shaded seating for residents. LPA observed ample emergency food and water. LPA reviewed the emergency disaster plan and infection control plan during the visit. Plans are thorough and complete. Facility conducts quarterly emergency drills with the last drill conducted on 03/30/2025. Facility provides activities in the form of games, exercise, and outings. LPA observed residents participating in activities during the visit. LPA spoke with residents during the visit who stated satisfaction with facility services and verbalized feeling safe. LPA observed no health or safety concerns during the visit. LPA reviewed select resident and staff files. Resident files contained required documents including admission agreements, current physician reports and resident appraisals. Staff files reviewed contained required documentation such as health screen/TB, and criminal record clearance. Due to time constraints, LPA to return at a later date to review medication administration and storage. Based on the observations made during today's visit, no deficiencies are being cited. Exit interview conducted and a copy of this report was given at time of visit.

Based on observations and interviews conducted, LPA is unable to corroborate the allegation. Therefore, the allegation is deemed unsubstantiated, meaning that although the allegation may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted with Administrator and a copy of this report was provided to facility.

Licensing Program Analysts (LPA) Amy Rodgers, made an unannounced visit to conduct the required One-Year Inspection to ensure substantial compliance with Title 22 regulations. LPA Rodgers was granted entry into the facility Executive Director Jeremiah Goodwin, after identifying herself and stating the purpose of the inspection. This facility serves one hundred and twenty (120) residents 60 and above; 64 ambulatory, 51 may be non-ambulatory, in which Five (5) residents may be bedridden, includes a 31 bed dementia unit with delayed egress. Hospice waver for 11. LPA was accompanied by Executive Director Goodwin during a tour of the facility. A tour of the facility was conducted which included a sample of resident units, the dining area, recreation rooms, and food storage areas. The facilities has three stories with the memory unit on floor two. Signal systems are in place and operational. PPE supplies are onsite. Passageways were free from obstructions. Facility does feature delayed egress doors on the second floor.. Each resident had clean and sufficient bed linens. All residents’ rooms were equipped with required furnishings. Lighting was present in the bedrooms. Residents’ bathrooms were observed to be sanitary and operational. Toilets and showers were equipped with grab bars and Non-skid strips. Hot water temperature in residents’ bathrooms were compliant. Carbon monoxide detectors, emergency lighting, and facility telephone were all working. Fire extinguisher(s) were in working order. First aid kit(s) were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. [CONTINUED ON LIC 809-C] 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 [CONTINUED FROM LIC 809] Facility has a two-day supply of perishable food and a seven-day supply of nonperishable food items. Food supply is replenished frequently by outside vendors. Food was observed to be properly stored and labeled. The food service area was observed to be neat and clean. Food menus and activities schedule were posted. Chemicals and cleaning supplies were stored in a locked closed room not assessable to residents. Centrally stored medications were properly stored and locked in a medication room and medication carts. Medication logs and medications reviewed were current and medications appear to be administered according to the label instructions. Staff records review verified that all staff records were complete and compliant. Resident records were reviewed and confirmed compliant. Administrator’s certification is current. LPA reviewed the theft and loss policy and procedures. LPA conducted a thorough review of In-service training procedures. Transportation procedures are compliant. LPA observed that residents were being treated with dignity by staff, and there were sufficient staff on duty to meet resident’s needs. An exit interview was conducted with Executive Director Goodwin, to whom copies of this report, and the Licensee/Appeal Rights (LIC9058 03/22) were provided at the conclusion of the visit. Their signature on this form acknowledges receipt and a copy of the report was given to Executive Director Goodwin.

staff S2 indicated that a call was made to R1’s POA when this occurred and that any time there was any adverse reaction or behavior with R1. S2 indicated that they have made those calls and indicated that R1’s POA is very involved with the care of R1 and therefore staff are very mindful of always providing information to POA. It is alleged that staff left resident in soiled diapers for an extended period of times. LPA conducted a site visit on June 10, 2024, and was unable to make observations to R1 as R1 had moved out of the facility May 01, 2024. Interviews with 1 of 2 staff indicated that R1 could get very combative at times and did not allow for staff to give R1 proper care until R1 would calm down. Based on the information available through record review and interviews, LPA is unable to corroborate or refute that a violation occurred as alleged as the information collected is conflicting. It is alleged that staff overmedicated resident. Records review MAR for January – May 2024 indicates that medication was given to R1 as indicated in prescription directions. MARs reflect that medication was given at the scheduled time per order indications. Interview with 1 of 2 staff revealed that medication is given as prescribed and there is no way staff can over medicate because that would cause a shortage on dosage that was needed for R1 to be given dosage as indicated per day. Staff indicated this would reflect on MAR, but however dosages are signed off as given as indicated on prescription instructions. It is alleged that staff did not notify authorized representative of new medication. Records revealed copies of doctor’s orders for medication on file for R1, and a completed MAR sheet for all medication for resident. Interview with 2 of 2 staff revealed that they would inform POA of anything that involved R1’s care. POA was very involved with residents’ care therefore staff at facility kept POA informed of care. Staff indicated that once ordered are received by the physician the medication is given according to the physician's directions. Based on the information available through record review and interviews, LPA is unable to corroborate or refute that a violation occurred as alleged as the information collected is conflicting. Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted with the Executive Director and a copy of this LIC9099 report was left at facility.

Based on LPA’s interviews which were conducted, review of documents obtained, and observations, LPA is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed UNSUBSTANTIATED. An exit interview was conducted with ED Goodwin. A copy of this report was provided and explained.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on incident report submitted to Community Care Licensing on 05/24/2022. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator Jeremiah Goodwin and Resident Services Director Irma Arreola were present during the visit. Incident report dated 05/22/2022 indicated Resident 1 (R1) was discovered by staff outside the facility in the parking lot. Staff redirected the resident back into the facility. Facility placed a one on one care companion with resident and advised family the companion would be needed until results of a urinalysis were received. Urinalysis was negative and family notified that R1 would need a permanent care companion or move into the memory care unit. Family declined and moved the resident out of the facility. Resident has had three documented elopements in the last 6 months. Physician report dated 05/24/2022 and 05/05/2021 both indicate a diagnosis of Dementia. No deficiencies noted during today's visit. Exit interview conducted and a copy of this report was left at the facility.

Licensing Program Analysts (LPAs) Celine De Perio and Albert Marin conducted an unannounced visit for the purpose of conducting a required annual visit. LPAs were greeted and granted entry into the facility by Executive Director (ED) Jeremiah Goodwin and explained the reason for the visit. ED also has an Administrator’s certificate that expiring on 07/27/2023. Facility has a COVID screening procedure that is completed per visitor with temperature check, and self-assessment questionnaire. At 9:30 AM, LPAs toured the facility with Administrator. Facility has eighty four residents in care during today's visit with 2 residents on hospice care, 31 in memory care and 53 in assisted living. Facility consists of Assisted Living and Memory Care “Life Guidance” units. LPAs observed residents relaxing, socializing, and participating in activities in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. Observed resident rooms had clean bed linens and rooms and bathrooms were free from odor. All rooms are observed to be single rooms, and in the memory care unit, two rooms with individual doors to separate the resident, with a shared bathroom. LPAs tested emergency pull cord in random rooms (Room #131 and #219) and was observed to be operational, and hot water temperatures were measured between 105-114 degrees Fahrenheit. Carbon monoxide detectors were observed in common hallways and are operational. LPAs toured the exterior ground of facility and observed multiple outside visitation areas with provided shaded areas. LPAs observed the medication room and medication cart used for residents with computer. LPAs observed that facility has posted the enlarged 20" x 26" "Let Us Know" poster. ED/AD presented the emergency disaster plan in facility. LPAs De Perio and Marin informed and reviewed the Coronavirus 2019 (COVID 19) mitigation plan of the facility with ED/AD Goodwin. LPAs discussed Assembly Bill 665 requires that a licensee of any adult or senior care residential facility that has internet service provide at least one internet access device, such as a computer, smart phone, tablet or other device, that: can support real-time interactive applications; is equipped with video conferencing technology, including microphone and camera functions; and is dedicated for client or resident use. Continued on Page 2. 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 LPAs observed first-aid kit with all required items in facility and in company vehicles along with all fire extinguishers charged. Facility annual fire alarm inspection was conducted on 12/15/2021 and 12/16/2021. Facility has emergency evacuation chairs at the top of both stairwells, and delayed egress door was tested and observed to be operational. LPAs observed an ample supply of emergency food and water. Facility provided documentation of fire inspection for each room, along with smoke detectors functions. No citation was issued during today's visit. LPAs De Perio and LPA Marin conducted. An exit interview was conducted with ED/AD Jeremiah Goodwin and a copy of this report was left at the facility.

Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced visit for the purpose of conducting a required/ annual visit. LPA was greeted and granted entry into the facility by Resident Services Director Irma Arreola and Executive Director Jeremiah Goodwin and explained the reason for the visit. Administrator Goodwin has a current administrator certificate expiring on 07/27/2023. At 1:00 PM, LPA toured the facility with Administrator and Resident Services Director. Facility has eighty six residents in care during today's visit with 3 residents on hospice care. Facility consists of Assisted Living and Memory Care units. LPA observed residents relaxing in the facility. All residents appeared happy and well taken care of. Facility appears clean and sanitary. All resident rooms had the required elements as well as restrooms stocked with soap/ sanitizer. All rooms observed are single occupancy. Facility screens all visitors to the facility and LPA observed the screening/ sanitizing station in the facility. Facility utilizes a visitor sign in sheet. Facility takes resident and staff temperatures daily and documents. Facility has covid precaution postings as well as department postings. LPA observed the first aid kit has all required items. Facility mitigation plan has been approved. Facility has emergency evacuation chairs at the top of both stairwells. LPA observed an ample supply of emergency food and water. Facility tests smoke detectors monthly and provided documentation of such. LPA toured the outside grounds and observed multiple outside visitation areas. LPA observed the medication room and facility uses electronic medical records for medication management. Facility has a plan for covid testing residents and staff as needed as well as a plan for isolation and quarantine. LPA reviewed select resident files during the visit and all files are up to date including emergency information. Most residents and all staff are vaccinated for Covid-19. LPA consulted with Administrator regarding the size of the "Let Us Know" poster. Facility to enlarge poster to 20" x 26" and re-post in facility. No deficiencies noted during today's visit. An exit interview was conducted and a copy of this report was left at the facility.