107201055-6-20-2024-24-AS-BCHN-D6LUJF-20240626153729

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107201055
Report Date: 05/22/2024
Date Signed: 06/20/2024 08:21:21 AM

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
02/16/2024 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20240216145521

FACILITY NAME:	GARDEN TERRACE ASSISTED LIVING II		FACILITY NUMBER:	107201055
ADMINISTRATOR:	HERGENROEDER, STEVE & JULI		FACILITY TYPE:	740
ADDRESS:	1743 E. CHENNAULT		TELEPHONE:	(559) 323-1083
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	6	CENSUS: 5	DATE:	05/22/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	staff Beatriz Duenas		TIME COMPLETED:	10:46 AM

ALLEGATION(S):

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Staff hit resident in care.
Staff did not provide adequate supervision resulting in resident sustaining injuries while in care.
Staff does not administer resident's medications as prescribed.
Staff does not dispose resident's expired medications.
Staff does not ensure resident's bathing needs are being met.
Staff does not allow residents to finish meals.

INVESTIGATION FINDINGS:

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This is amended of the original report.
On 05/22/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility staff Beatriz and stated the purpose of the visit. AD was notified of Licensing visit. During this visit LPA toured the facility inside and out and observed residents in care. Once the tour was complete, LPA discussed the findings.

Allegation: Staff hit resident in care. Based of history file review and observations and staff interview no incident reports of staff hit residents reported or documented. Residents interviewed stated they did not witness staff abuse residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

Report continues on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Vadim Gorban	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

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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Control Number 24-AS-20240216145521

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: GARDEN TERRACE ASSISTED LIVING II	FACILITY NUMBER: 107201055
	VISIT DATE: 05/22/2024

NARRATIVE

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This is amended of the original report

Allegation: Staff did not provide adequate supervision resulting in resident sustaining injuries while in care. Based of observations on 2/22/24 and 4/19/24, interviews and records reviews, the facility providing adequate supervision to residents in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

Allegation: Staff does not administer resident's medications as prescribed. Based of records review R2 refused to take her medications . Licensing department and R2's physician was notified. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

Allegation: Staff does not dispose resident's expired medications. Based of observations on 2/22/24, interview and records review, no expired medications observed. Per staff interview, facility administrator disposes expired medications. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

Allegation: Staff does not ensure resident's bathing needs are being met. Based of interview and records review residents receive bath as scheduled. Per interviews, alternative bath provided to residents unable to stand and residents always resume the rights to refuse baths. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

Allegation: Staff does not allow residents to finish meals. Based of observations of residents during meals on 2/22 and 4/19/24, and interviews facility residents were not rushed or denied finishing meals. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

No deficiencies were cited during this visit. Exit interview conducted, report signed and copy of this report provide to AD for facility records.

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Vadim Gorban	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024

LIC9099 (FAS) - (06/04)

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