543801694-6-2-2021-04-CC-DLEN-C4ULUU-20210712090428

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 543801694
Report Date: 06/02/2021
Date Signed: 06/02/2021 10:55:18 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/03/2021 and conducted by Evaluator Peter Espinoza

COMPLAINT CONTROL NUMBER: 04-CC-20210503100202

FACILITY NAME:	FAMILY F.O.C.U.S.		FACILITY NUMBER:	543801694
ADMINISTRATOR:	TANNER, PRUDY J		FACILITY TYPE:	830
ADDRESS:	1504 S. KESSING		TELEPHONE:	(559) 784-2214
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	45	CENSUS: 0	DATE:	06/02/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Kawanda Pettitt Program Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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9

Personal Rights

INVESTIGATION FINDINGS:

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13

On 06/02/2021, Licensing Program Analyst (LPA) Pete Espinoza met with Kawanda Pettitt, Program Director to complete the investigation into the above allegation.

Based upon information gathered through interviews, this agency has investigated the complaint alleging Personal Rights. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegations are UNSUBSTANTIATED. A printed copy of the report as well as a printed copy of appeal rights was provided to Kawanda Pettitt, Program Director at the conclusion of the visit.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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