Inspection Reports for Atria Sunnyvale

CA, 94087

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Inspection Report Annual Inspection Census: 92 Capacity: 160 Deficiencies: 3 Jun 5, 2025
Visit Reason
The inspection was an unannounced Required 1-Year Annual inspection conducted to evaluate compliance with licensing requirements at the facility.
Findings
The facility was generally found to be clean, well-maintained, and compliant in many areas including resident rooms, kitchen, common areas, and emergency equipment. However, deficiencies were cited related to medication administration errors, hot water temperature exceeding regulatory limits, and incomplete documentation regarding residents' medication self-administration abilities.
Severity Breakdown
Type A: 1 Type B: 2
Deficiencies (3)
DescriptionSeverity
The licensee did not ensure 3 medications were correctly administered to 1 of 5 residents (R1), posing an immediate health, safety or personal rights risk.Type A
Hot water temperature was measured above 120°F in 8 of 10 random rooms, exceeding the allowed range of 105°F-120°F, posing a potential health, safety or personal rights risk.Type B
The licensee did not ensure R2's physician had stated in writing that the resident is able to determine and communicate his/her need for medication, while a pillbox with medication was observed in R2's room, posing a potential health, safety or personal rights risk.Type B
Report Facts
Residents present: 92 Total licensed capacity: 160 Rooms inspected: 10 Medication errors: 3 Rooms with hot water above 120°F: 8 Residents reviewed for medication self-administration documentation: 5 Staff personnel records reviewed: 6
Employees Mentioned
NameTitleContext
Flavio SilvaExecutive DirectorMet with Licensing Program Analyst during inspection and involved in plans of correction
Kiran JainLicensing Program AnalystConducted the inspection and authored the report
April CowanLicensing Program ManagerOversaw the licensing program and signed the report
Inspection Report Census: 88 Capacity: 160 Deficiencies: 0 Apr 2, 2025
Visit Reason
The visit was an unannounced Case Management - Incident inspection regarding a death report for Resident 1 (R1) received by the department on March 25, 2025.
Findings
The inspection found that R1 had a fall on March 18, 2025, was transported to the hospital, and subsequently passed away. The facility had submitted an Unusual Incident Report timely. No deficiencies were cited during the visit.
Report Facts
Facility census: 88 Facility capacity: 160
Employees Mentioned
NameTitleContext
Flavio SilvaExecutive DirectorMet with Licensing Program Analyst during the inspection and provided information about the incident
Kiran JainLicensing Program AnalystConducted the inspection visit
Inspection Report Complaint Investigation Census: 104 Capacity: 160 Deficiencies: 1 Jan 2, 2025
Visit Reason
The inspection was a Case Management – Incident visit regarding three separate incidents involving medication errors and resident falls that occurred on 12/23/2024, 12/22/2024, and 11/27/2024.
Findings
The investigation found that resident R1 was given the wrong medication and resident R2 was not given medication on 12/23/2024. Resident R3 was found with unexplained bruises on 12/22/2024, and resident R4 had multiple fall incidents reported on 11/27/2024. A deficiency was cited related to medication administration errors.
Complaint Details
The visit was complaint-related involving three incidents: medication errors on 12/23/2024, unexplained bruises on 12/22/2024, and multiple falls on 11/27/2024. The medication errors were substantiated with a cited deficiency.
Severity Breakdown
Type A: 1
Deficiencies (1)
DescriptionSeverity
Failure to ensure resident R1 was given the right medication and dosage on 12/23/2024 morning, and resident R2 was not given medication on 12/23/2024 morning despite MAR showing medication was given.Type A
Report Facts
Incidents reported: 3 Census: 104 Total capacity: 160 Plan of Correction due date: Jan 3, 2025
Employees Mentioned
NameTitleContext
Flavio SilvaExecutive DirectorInterviewed regarding incidents and findings
Kiran JainLicensing Program AnalystConducted inspection and interviews
April CowanLicensing Program ManagerSupervisor of the inspection
Resident Services DirectorStaff member involved in medication administration during incident
Inspection Report Complaint Investigation Census: 105 Capacity: 160 Deficiencies: 0 Dec 10, 2024
Visit Reason
The inspection visit was an unannounced complaint investigation triggered by a complaint received on 2023-09-11 regarding allegations that staff were not returning authorized representative's calls and did not seek timely medical care for a resident.
Findings
The investigation found both allegations to be unsubstantiated. Facility staff demonstrated they had contacted the authorized representative after an incident, and there was no proof of delay in performing CPR on the resident as alleged.
Complaint Details
The complaint involved two allegations: 1) staff not returning authorized representative's calls, and 2) staff not seeking timely medical care for a resident. Both allegations were investigated and deemed unsubstantiated due to lack of evidence supporting the claims.
Report Facts
Capacity: 160 Census: 105
Employees Mentioned
NameTitleContext
Flavio SilvaExecutive DirectorMet with Licensing Program Analyst during the complaint investigation
Komal CharitraLicensing Program AnalystConducted the complaint investigation
Cowan AprilLicensing Program ManagerReviewed and signed the complaint investigation report
Inspection Report Annual Inspection Census: 98 Capacity: 160 Deficiencies: 0 Jun 25, 2024
Visit Reason
An unannounced Required 1 Year visit was conducted to evaluate the facility's compliance with regulations.
Findings
The inspection found no deficiencies cited per California Code of Regulations, Title 22. A technical violation was provided during the visit. The facility was toured including resident bedrooms, kitchen, and safety equipment, all found in compliance.
Report Facts
Food supply duration: 2 Food supply duration: 7 Fridge temperature: 40 Freezer temperature: 0 Water temperature range: 118.9 Water temperature range: 119.8 Fire extinguisher inspection date: Jan 31, 2024 Smoke and carbon monoxide detectors inspection date: Jan 31, 2024 Last disaster drill date: May 19, 2024 Staff records reviewed: 5 Resident records reviewed: 5
Employees Mentioned
NameTitleContext
Flavio SilvaAdministratorMet with Licensing Program Analyst during inspection and discussed findings
Simranjit RaiLicensing Program AnalystConducted the inspection visit
Inspection Report Complaint Investigation Census: 88 Capacity: 160 Deficiencies: 0 Feb 29, 2024
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation that staff caused an injury to a resident while in care due to abuse.
Findings
The investigation found no preponderance of evidence to prove the alleged abuse occurred. Interviews and records review indicated the resident felt safe, and staff denied any abuse. The allegation was determined to be unsubstantiated.
Complaint Details
The complaint alleged that a staff member caused an injury to a resident by applying enough pressure during a transfer to leave a bruise. Interviews with the resident and staff, as well as records review, did not substantiate the allegation.
Report Facts
Capacity: 160 Census: 88
Employees Mentioned
NameTitleContext
Grace DonatoLicensing Program AnalystConducted the complaint investigation visit and delivered findings
Byron PerrymanAdministratorFacility administrator named in the report header
Cathy PlatonResident Services DirectorMet with Licensing Program Analyst during the investigation
Jackie JinLicensing Program ManagerNamed as Licensing Program Manager overseeing the investigation
Inspection Report Complaint Investigation Census: 67 Capacity: 160 Deficiencies: 0 Apr 4, 2023
Visit Reason
The inspection was an unannounced complaint investigation visit triggered by an allegation of financial abuse of a resident.
Findings
The investigation found the complaint allegation to be unfounded after interviews with residents, staff, and a family member, and review of records. No evidence of financial abuse or theft was observed or reported by staff or residents.
Complaint Details
The complaint alleged that a resident was being financially abused. The investigation included interviews with residents R1-R6, staff S1-S9, and R1's family member FM1. Resident R1 reported fraudulent bank charges after responding to a pop-up alert, but the agency found no evidence that the facility staff were involved. The complaint was determined to be unfounded.
Report Facts
Capacity: 160 Census: 67
Employees Mentioned
NameTitleContext
David MarrufoLicensing Program AnalystConducted the complaint investigation visit
Kris WaluszkoRegional Vice PresidentMet with the Licensing Program Analyst during the investigation
Flavio SilvaAdministratorFacility administrator named in the report
Sarah YipLicensing Program ManagerNamed as Licensing Program Manager on the report
Inspection Report Annual Inspection Census: 95 Capacity: 160 Deficiencies: 0 Jun 10, 2022
Visit Reason
An unannounced infection control site visit was conducted as part of the required 1-year inspection.
Findings
The facility was found to be in compliance with infection control standards, with adequate PPE supplies, proper food storage and preparation, and clean, well-stocked restrooms. No deficiencies were cited during the visit.
Report Facts
Capacity: 160 Census: 95
Employees Mentioned
NameTitleContext
Byron PerrymanExecutive DirectorMet with Licensing Program Analysts during the inspection
Mandeep KaurLicensing Program AnalystConducted the inspection
David MarrufoLicensing Program AnalystConducted the inspection
Sarah YipLicensing Program ManagerNamed in report header
Inspection Report Complaint Investigation Capacity: 160 Deficiencies: 1 Jun 10, 2022
Visit Reason
The visit was an unannounced Case Management follow-up to an incident report submitted by the facility regarding a resident who was missing from the facility but returned the same day.
Findings
A deficiency was cited because the facility did not ensure that resident R1, who is not permitted to leave unassisted, was provided necessary assistance to prevent leaving the facility unassisted, posing an immediate risk to the resident's health and safety.
Complaint Details
The visit was triggered by a complaint/incident report that resident R1 was missing from the facility on 06/02/2022 and returned the same day. The resident is not permitted to leave unassisted according to their care plan and physician's report.
Deficiencies (1)
Description
Licensee did not ensure that resident R1, who cannot leave the facility unassisted, was provided the necessary assistance to ensure R1 did not leave the facility unassisted, posing an immediate risk to the health and safety of the resident in care.
Report Facts
Capacity: 160
Employees Mentioned
NameTitleContext
Byron PerrymanAdministratorMet with Licensing Program Analysts during the visit and discussed the incident
David MarrufoLicensing Program AnalystConducted the inspection and authored the report
Mandeep KaurLicensing Program AnalystConducted the inspection
Jackie JinLicensing Program ManagerSupervisor of the licensing evaluation
Inspection Report Complaint Investigation Census: 94 Capacity: 160 Deficiencies: 0 Oct 12, 2021
Visit Reason
An unannounced complaint investigation was conducted following a complaint received on 08/24/2020 alleging lack of supervision resulting in residents being assaulted by another resident.
Findings
The investigation included interviews with staff and review of police and staff schedule records. The allegation was found to be unsubstantiated due to lack of preponderance of evidence, with staff denying lack of supervision and confirming timely response to the incident.
Complaint Details
The complaint alleged lack of supervision resulting in residents being assaulted by another resident. The investigation included interviews with 1 resident and 6 staff, review of police report, and staff schedules. The police report noted the case was inactive due to dementia diagnoses of involved residents. The allegation was determined to be unsubstantiated.
Report Facts
Staff on duty: 3 Staff on duty: 2 Resident census: 94 Facility capacity: 160
Employees Mentioned
NameTitleContext
Yatfai Eric NgLicensing Program AnalystConducted the complaint investigation
Byron PerrymanExecutive DirectorMet with Licensing Program Analyst during investigation
Sarah YipLicensing Program ManagerNamed in report as Licensing Program Manager
Inspection Report Complaint Investigation Census: 92 Capacity: 160 Deficiencies: 0 Jun 8, 2021
Visit Reason
An unannounced complaint investigation was conducted in response to an allegation that facility staff were not following a resident's dietary needs.
Findings
The investigation found that the alleged victim did not reside at the facility, and the allegation was determined to be unfounded based on interviews and record review.
Complaint Details
The complaint was investigated and found to be unfounded, meaning the allegation was false, could not have happened, and/or was without a reasonable basis.
Report Facts
Capacity: 160 Census: 92
Employees Mentioned
NameTitleContext
Yatfai Eric NgLicensing Program AnalystConducted the complaint investigation visit
Byron PerrymanExecutive DirectorMet with Licensing Program Analyst during investigation
Flavio SilvaAdministratorFacility administrator named in report header
Sarah YipLicensing Program ManagerNamed as Licensing Program Manager overseeing the investigation
Inspection Report Routine Census: 93 Capacity: 160 Deficiencies: 0 May 26, 2021
Visit Reason
An unannounced infection control site visit was conducted as part of the required 1-year routine inspection.
Findings
The facility was observed to be in sanitary condition with all staff wearing masks, adequate PPE supplies, and proper COVID-19 screening procedures in place. No deficiencies were cited during the visit.
Report Facts
Capacity: 160 Census: 93
Employees Mentioned
NameTitleContext
Byron PerrymanExecutive DirectorMet with Licensing Program Analyst during the inspection
Yatfai Eric NgLicensing Program AnalystConducted the unannounced infection control site visit
Sarah YipLicensing Program ManagerNamed in the report header
Inspection Report Complaint Investigation Census: 93 Capacity: 160 Deficiencies: 0 Feb 5, 2021
Visit Reason
The visit was conducted as an unannounced Case Management - Incident tele-visit to respond to an incident report received on 2021-02-03 regarding inappropriate touching of resident R1 by resident R2.
Findings
The Licensing Program Analyst interviewed the Executive Director and resident R1. R1 was placed on the first floor and R2 on the second floor with escort services to ensure safety. R1 had not seen R2 since the incident and felt safe and satisfied with the facility's services. No deficiencies were cited during the visit.
Complaint Details
The incident report alleged that resident R1 was touched inappropriately by resident R2. The case management remained open pending additional reports.
Employees Mentioned
NameTitleContext
Byron PerrymanExecutive DirectorMet with Licensing Program Analyst during the incident investigation.
Yatfai Eric NgLicensing Program AnalystConducted the unannounced Case Management - Incident tele-visit.
Sarah YipLicensing Program ManagerNamed in the report as Licensing Program Manager.
Inspection Report Census: 91 Capacity: 160 Deficiencies: 0 Jan 8, 2021
Visit Reason
The visit was a Case Management - Other tele-visit conducted via FaceTime to provide technical assistance to prevent and mitigate the spread of COVID-19 at the facility.
Findings
The Licensing Program Analyst and Health Facilities Evaluator Nurse conducted a virtual tour of the facility and observed infection control practices. Recommendations were made to improve social distancing and staff screening. No deficiencies were cited during the visit.
Report Facts
Capacity: 160 Census: 91
Employees Mentioned
NameTitleContext
Byron PerrymanAdministratorMet with Licensing Program Analyst and Health Facilities Evaluator Nurse during the visit
Yatfai Eric NgLicensing Program AnalystConducted the case management tele-visit
Veronica NazarethHealth Facilities Evaluator NursePartnered in conducting the case management tele-visit

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