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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107201015
Report Date: 12/20/2024
Date Signed: 12/20/2024 03:12:09 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
09/09/2024 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20240909134612
FACILITY NAME:EDDIE'S TERRACE #6FACILITY NUMBER:
107201015
ADMINISTRATOR:HENDRICKS, STEPHANIEFACILITY TYPE:
735
ADDRESS:1283 WEST TWAIN AVENUETELEPHONE:
(559) 224-4185
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 3DATE:
12/20/2024
UNANNOUNCEDTIME BEGAN:
03:02 PM
MET WITH:Administrator, Maricia AlvaradoTIME COMPLETED:
03:03 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff spoke inappropriately to resident
Facility staff did not safeguard resident's personal belongings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 12/20/24 Licensing Program Analyst (LPA) M. Garza completed an unannounced complaint visit to deliver findings. LPA met with Administrator, Maricia Alvarado and explained reason for visit.

During complaint investigation the Department completed interviews (RP, staff, clients and family members) reviewed documentation (Staff roster with contact information from April 2024 to current, staff schedule for April 2024 to September 2024, resident roster April 2024 to September 2024, resident inventory sheets April 2024 to September 2024, training records for staff, IPP’s, admission agreements). Interviews with staff and residents do not support the allegation of staff speaking inappropriately to residents. Review of records show belonging entering into the facility with R1. At time of move out Service Coordinator and R1 attended a meeting to gather their belonging. Interviews disclosed R1 sold their belongings prior to moving out of the facility to an unknown person for additional funds. Although the allegation may or may not have occurred it does not meet the preponderance of evidence standard per Title 22. The allegations listed above are UNSUBSTANTIATED.

Exit interview completed with Administrator, Maricia. A copy of this report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
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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