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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 100408901
Report Date: 10/30/2023
Date Signed: 10/30/2023 02:21:39 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/17/2023 and conducted by Evaluator Kelly J. McClurg
COMPLAINT CONTROL NUMBER: 24-AS-20230817142722
FACILITY NAME:GARDEN MANORFACILITY NUMBER:
100408901
ADMINISTRATOR:BLACK, JOANFACILITY TYPE:
740
ADDRESS:4983 E. OLIVETELEPHONE:
(559) 255-8650
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:49CENSUS: DATE:
10/30/2023
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Administrator Assistant (AA) Joanna Tilghman (by phone) & Bonnie TIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not ensure facility was kept free of pests.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A Complaint visit was conducted on the date & time above. Licensing Program Analyst (LPA) K. McClurg called posted phone number for drive-in gate to be opened. LPA spoke with Administrator Assistant (AA) Joanna Tilghman over the phone, stated purpose of visit, & AA agreed to have House Manager (HM) Bonnie Martin.

Pest Control services contacted immediately. Pest Control Service receipts/invoices support this along with continued treatment until could complete & confirm eradication of bed bugs. Facility followed appropriate policies and procedures.

The Department has investigated the above allegation & determined it to be Unfounded.

Exit interview conducted with HM. Report provided.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) 580-4596
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
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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