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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 100404229
Report Date: 07/21/2023
Date Signed: 07/21/2023 03:30:07 PM

Unsubstantiated


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
05/03/2023 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230503134856
FACILITY NAME:STEPHANIE'S HOUSE A HOME FOR SPECIAL PEOPLEFACILITY NUMBER:
100404229
ADMINISTRATOR:SNYDER, ELSA V.FACILITY TYPE:
735
ADDRESS:42825 WEST VALERIATELEPHONE:
(209) 392-3778
CITY:DOS PALOSSTATE: CAZIP CODE:
93620
CAPACITY:13CENSUS: 13DATE:
07/21/2023
UNANNOUNCEDTIME BEGAN:
03:24 PM
MET WITH:Administrator- Elsa SynderTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Facility has pest problem
INVESTIGATION FINDINGS:
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On 7/21/2023 at 3:24 p.m. Licensing Program Analyst B. Miranda arrived to the facility unannounced to deliver findings for the allegations listed above. LPA introduced herself and explained the reason for the visit with Administrator (AD) Elsa Snyder.

1. The Department investigated the allegation: Facility has pest problem. LPA conducted interviews with residents and staff on 5/8/23. Interviewees stated there was previously a pest problem and the issue has since been resolved. LPA toured the facility and was unable to observe a pest problem. The facility is located out in the countryside. LPA observed pests traps under residents beds which is used to help alleviate any pest issues. Administrator also verified pest control sprays at the facility once a month.



Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
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 2
Control Number 24-AS-20230503134856
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: STEPHANIE'S HOUSE A HOME FOR SPECIAL PEOPLE
FACILITY NUMBER: 100404229
VISIT DATE: 07/21/2023
NARRATIVE
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Licensing Program Analyst (LPA) B. Miranda conducted the complaint investigation visit to the facility on 5/8/23. During the course of this complaint investigation LPA interviewed residents, caregivers on duty, administrator, and observed the facility. It was determined based on the interviews and observation that the above allegation is Unsubstantiated.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted and a copy of this report was provided to AD Elsa Snyder.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2