<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 100400622
Report Date: 10/18/2023
Date Signed: 10/18/2023 03:09:47 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/21/2023 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20230421161225
FACILITY NAME:TWILIGHT HAVENFACILITY NUMBER:
100400622
ADMINISTRATOR:RAMIREZ, SYLVIAFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(559) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 30DATE:
10/18/2023
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:CEO Kristine William via telephone and Accounts Payable Beth MuellerTIME COMPLETED:
12:54 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is in Financial Distress
Reporting Requirements
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/18/23, Licensing Program Analysts (LPA) M. Yang and L. Padgett arrived unannounced to deliver findings on the above allegations. LPAs introduced self, stated the purpose of the visit, and met with Account Payable Beth Mueller. CEO Kristine Williams was called and unable to attend meeting. LPAs deliver findings via telephone.

The Department conducted interviews and reviewed records regarding the allegations. The Department was informed by CDPH of the facility’s financial issues after the SNF closed. It was discovered that funds between the skilled nursing facility and assisted living were co-mingled and the assisted living was affected. Based on LPA’s observations and interviews which were conducted and record reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.
Under California Code of Regulations, Title 22, Division 6 & Chapter 8, are being cited. See citations on the attached LIC. 9099D. Exit interview was conducted. A copy of this report and appeal rights was provided to CEO via email as requested. Signed report on file.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/21/2023 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20230421161225

FACILITY NAME:TWILIGHT HAVENFACILITY NUMBER:
100400622
ADMINISTRATOR:RAMIREZ, SYLVIAFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(559) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 30DATE:
10/18/2023
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:RCFE Operations Manager (OM) Kristine William via telephone and Accounts Payable Beth MuellerTIME COMPLETED:
12:54 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Administrator Qualifications
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/18/23, Licensing Program Analyst (LPA) M. Yang and L. Padgett arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit, and met with Account Payable Beth Mueller. CEO Kristine Williams was called and unable to attend meeting. LPAs deliver findings via telephone.

The Department conducted interviews and reviewed records. During the course of the investigation, the facility had an Administrator at the facility. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. Exit interview was conducted. A copy of this report was provided to CEO via email as requested. Signed report on file.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20230421161225
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: TWILIGHT HAVEN
FACILITY NUMBER: 100400622
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/19/2023
Section Cited
CCR
87213
1
2
3
4
5
6
7
Finances - The licensee shall have a financial plan that conforms to the requirements of Section 87155, Application for License, and that assures sufficient resources to meet operating costs for care of residents; shall maintain adequate financial records…this requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Licensee continues to be in communication with the Department regarding its finances. A plan was submitted to the CCL office and the facility will continue to update the Department during this process. There has been no disruption to services and staffing during this time. ***POC cleared during the inspection.***
8
9
10
11
12
13
14
Based on interviews conducted and records reviewed, the facility does not have sufficient funds, which poses a potential health, safety, and personal rights risk to the residents in care.
8
9
10
11
12
13
14
Type B
10/19/2023
Section Cited
CCR
87211(d)(1)
1
2
3
4
5
6
7
Reporting Requirements - The licensee shall notify the Department…in writing within two business days of any of the following specified events…this requirement was not met as evidenced by:
1
2
3
4
5
6
7
The licensee was informed of its reporting requirements and have since been in communication with the Department regarding its financial status. ***POC cleared during the inspection.***
8
9
10
11
12
13
14
Based on interviews conducted, the facility failed to inform the Department of its financial issues and co-mingling of funds with the closed SNF, which poses a potential health and safety risk to the clients in care.

8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3