Inspector’s narrative
What the inspector wrote
[CONTINUED FROM LIC 9099]
Records and interviews showed: On 01/08/2026, Licensee served R1 with a written thirty (30) day notice eviction letter due to non-payment of rent. The letter read, in part: “This letter (the “Notice”) constitutes thirty day’s notice to pay or your Residency Agreement dated 5/31/2023 (the “Agreement”) with Atria Collwood, License No. 374600890 (the “Community”) will be terminated pursuant to the Agreement. This Notice is based on your non-payment of all fees and charges within ten days of the due date. The total amount now due and owing as of the date of this letter is: $15,054.00. You must pay this amount by 2/21/2026, or within thirty days of service of this Notice upon you, whichever is later (the “Effective Date”). Unless you pay this amount, you are required to move from and surrender possession of your apartment on or before the Effective Date.” This letter included various elements customary and required in RCFE eviction letters, such as the disclaimer paragraph specified in HSC 1569.683(a)(4), a disclaimer about the resident’s right to file a complaint and contact information for CCLD and the Long-Term Care Ombudsman, and resources available to assist in identifying alternative housing and care options.
However, LPA’s review of R1’s monthly billing statements, confirmed by interview of the facility’s Community Business Director, showed: As of 01/08/2026, the date of service of R1’s eviction letter, R1’s total unpaid past due balance owed to Licensee was $14,829.00. Of this past due balance, the portion/segment that was over ten (10) days past due was $8,707.00. [Per CCR 87224(a)(1), a Licensee may issue a “thirty (30) days written notice” to a resident for “nonpayment of the rate for basic services within ten days of the due date.”] For an eviction letter dated and served on 01/08/2026, it was only this last amount which Licensee was legally allowed to list. Also, the amount listed in Licensee’s eviction letter to R1 did not match the amount listed in Licensee’s own monthly billing statement issued to R1.
Based on records and interviews, a preponderance of evidence exists to show that Licensee pursued an unlawful eviction of R1. The allegation is therefore Substantiated, and one (1) deficiency was cited for it, per California Code of Regulations, Title 22 (refer to the attached LIC 9099-D page). A Plan of Correction was jointly developed with the Licensee.
An exit interview was conducted with Executive Director Julia Lopez and Community Business Director Kitty Totorica, to whom a copy of this report, the LIC 9099-D page, the LIC811 Confidential Names List, and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
[CONTINUED FROM LIC 9099-A]
Records and interviews showed: R1 moved into the facility during May 2023 and was their own payee and responsible person. Per R1’s LIC602 Physician’s Reports, since move-in, R1 has been diagnosed with Lung Cancer, Chronic Obstructive Pulmonary Disease (COPD), Gait Instability, and Fatigue. R1 did not have Dementia or Mild Cognitive Impairment (MCI) and showed no sign of memory loss to LPA. While R1 had a diagnosis of Schizophrenia, R1 also displayed to LPA that they were fully oriented to persons, time, date, and place.
Electronic date and timestamped charting/progress notes, corroborated by facility care records and care staff interviews, showed: For most of R1’s residency, R1 was independent in Activities of Daily Living (ADLs), requiring no care services from Licensee, beyond basic room and board. However, R1 had a general worsening in their baseline breathing ability during the complaint period. For example, between 08/11/2025 and 01/12/2026, facility staff called 911 on at least six (6) separate occasions due to R1’s difficulty breathing / shortness of breath episodes. Following one of their hospital visits in September 2025, a foley-type urinary catheter was prescribed to R1 (which R1 continues to use).
R1’s updated LIC602 Physician’s Report from 09/16/2025 mentioned R1 having “acute lower respiratory infection,” “acute hypoxic respiratory failure,” “elevated brain natriuretic peptide level” (indicates increased stress, pressure, or fluid overload on the heart), and “urinary retention due to benign prostatic hyperplasia.” R1’s updated LIC602 Physician’s Report from 12/30/2025 mentioned R1 having “acute hypoxic and hypercapnic failure,” “COPD exacerbation,” and earlier “pneumonia.”
On 10/22/2025, Licensee performed a formal care plan reassessment / reappraisal on R1, determining that R1, as of that date, required caregiver assistance with dressing once (1) per day, catheter care four (4) times per day, daily housekeeping, visual status checks three (3) times per day, and scheduled meal tray / room service three (3) times per day. These changes placed R1 at what Licensee called “Level 3” Care. On 01/22/2026, Licensee performed a second formal care plan reassessment / reappraisal on R1, determining that R1, as of that date, no longer required dressing assistance or meal tray / room service. However, R1 continued to require catheter care four (4) times per day and daily housekeeping. Also, visual status checks on R1 increased to six (6) times per day. These changes placed R1 at what Licensee called “Level 2” Care. [CONTINUED ON LIC 9099-C, 2 of 2]
[CONTINUED FROM LIC 9099-C, 1 of 2]
CCLD concluded that Licensee’s 10/22/2025 and 01/22/2026 care reappraisals / reassessments of R1’s needs were reasonable, given R1’s overall change in condition. Although R1 claimed that Licensee did not clearly explain to them how their monthly costs would change in connection with these care level changes, R1’s signature did appear on each of these reassessment / reappraisal documents. Manager interviews showed License verbally explained to R1 how their costs would change, and did mail R1 written disclosures reflecting the changes in their costs (i.e., showing before vs. after). Interview of R1, combined with interviews of multiple frontline caregivers and housekeepers, showed that Licensee’s staff delivered the above assessed care services to R1, in practice, during the effective dates. LPA also reviewed date-stamped electronic care task logs, which showed facility caregivers consistently initialed/signed that these assessed care tasks were delivered to R1 during the effective dates, in practice.
Based on records and interviews, a preponderance of evidence does not exist to show that Licensee charged R1 for services not provided. The allegation is therefore Unsubstantiated, and no deficiency was cited for it.
An exit interview was conducted with Executive Director Julia Lopez and Community Business Director Kitty Totorica, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.
