100400622-5-22-2026-24-AS-SMOA-DUHLYN-20260528091036

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 100400622
Report Date: 05/22/2026
Date Signed: 05/22/2026 02:24:47 PM

Unsubstantiated

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
07/16/2025 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20250716141117

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:	0	CENSUS: 0	DATE:	05/22/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Radhika Jawa - Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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9

Facility is not sufficient in numbers to meet resident needs

INVESTIGATION FINDINGS:

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On 5/22/2026, Licensing Program Analyst M. Medina and Licensing Program Manager S. Moua met with the facility licensee and administrator. Finding was delivered for the above allegation.

The department has investigated the above allegation. During the course of the investigation, LPA toured the facility, conducted interviews, and reviewed documentation.

The department has insufficient information regarding the above allegation. 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.

No deficiencies were issued.

Exit interview conducted and a copy of report provided for facility records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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 2

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
07/16/2025 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20250716141117

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:	0	CENSUS: 0	DATE:	05/22/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Radhika Jawa - Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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9

Facility failed to schedule transportation arrangements as agreed upon resulting in missed medical appointments.
Facility does not provide supervision or have a safety plan in place for a residnet with Dementia who smokes cigarettes.

INVESTIGATION FINDINGS:

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7
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9
10
11
12
13

On 5/22/2026, Licensing Program Analyst M. Medina and Licensing Program Manager S. Moua met with the facility licensee and administrator. Finding was delivered for the above allegations.

The department has investigated the above allegations. During the course of the investigation, LPA toured the facility, conducted interviews, and reviewed documentation.

The Department has found that the above allegations are UNFOUNDED, meaning they were false, could not have happened, and/or were without reasonable basis. We have therefore dismissed the complaint.

No deficiencies were issued.

Exit interview conducted and a copy of this report was provided for facility records

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2026

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 2