100400622-10-9-2024-24-AS-SPIY-DABKVN-20241023081434

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 100400622
Report Date: 10/09/2024
Date Signed: 10/09/2024 03:04:13 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
10/07/2024 and conducted by Evaluator Rachel A Bruce

COMPLAINT CONTROL NUMBER: 24-AS-20241007085706

FACILITY NAME:	STONEHAVEN SENIOR LIVING		FACILITY NUMBER:	100400622
ADMINISTRATOR:	CARTER, BENJAMIN		FACILITY TYPE:	740
ADDRESS:	1717 SOUTH WINERY AVENUE		TELEPHONE:	(559) 251-8417
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	116	CENSUS: 48	DATE:	10/09/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	JayCee Sanderson, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff inappropriately removed the CCL complaint poster

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On October 9, 2024 Licensing Program Analyst (LPA) R Bruce met with Administrator, Jay Cee Sanderson for the purpose of delivering findings regarding the above allegation.

During the course of this investigation LPA reviewed facility files relevant to the complaint investigation, including resident files and medical records. A tour of the facility provided evidence that the 'See Something- Say Something' infromation poster was appropriately posted throughout the facility. As a result of the inspection, LPA determined the facility did not remove the required poster and has determined that the above allegation is UNFOUNDED and Community Care Licensing is therefore dismissing the complaint.

Resident expressed concern that the facility was trying to ensure that no one could complain. While at today's visit, an additional poster will be positioned outside the resident's room so he can easily see it and utilize the complaint line when necessary.
A copy of this report was provided to the Administrator during today's visit.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Rachel A Bruce	TELEPHONE: (559) 470-9001
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

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 1