107200486-2-23-2024-24-AS-SPIY-D2WNRC-20240229094115

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107200486
Report Date: 02/23/2024
Date Signed: 02/23/2024 09:36:51 AM

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
12/13/2023 and conducted by Evaluator Miriam Flores

COMPLAINT CONTROL NUMBER: 24-AS-20231213150724

FACILITY NAME:	SIERRA PALACE FOR ELDERLY		FACILITY NUMBER:	107200486
ADMINISTRATOR:	PERERA-MORELAND, ELIZABETH		FACILITY TYPE:	740
ADDRESS:	607 E. SIERRA AVENUE		TELEPHONE:	(559) 435-6345
CITY:	FRESNO	STATE: CA	ZIP CODE:	93710
CAPACITY:	6	CENSUS: 6	DATE:	02/23/2024
		UNANNOUNCED	TIME BEGAN:	08:28 AM
MET WITH:	Lisa Luna		TIME COMPLETED:	09:55 AM

ALLEGATION(S):

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Staff do not transport residents to hospital as needed
Staff force residents to attend day program

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced for subsequent complaint inspection. LPA discussed the purpose of the visit and the elements of the allegations with House Manager, Lisa Luna. Administrator, Elizabeth gave a verbal consent for this LPA to have this inspection with House Manager, Lisa Luna. LPA delivered the following findings:

During the course of this investigation LPA reviewed facility files and completed interviews relevant to the complaint investigation. It was determined that the above allegations: Staff do not transport residents to hospital as needed and Staff force residents to attend day program are UNFOUNDED. This agency has investigated the complaint alleging, Staff do not transport residents to hospital as needed and Staff force residents to attend day program. We have found that the complaint was unfounded, therefore we have dismissed the allegations.

An exit interview was conducted and a copy of this report was provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) -24-0610
LICENSING EVALUATOR NAME: Miriam Flores	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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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