107201156-7-15-2021-24-AS-MHON-C54UR7-20210720154813

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107201156
Report Date: 07/15/2021
Date Signed: 07/15/2021 04:34:03 PM

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
07/07/2021 and conducted by Evaluator Malia Thao

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20210707083733

FACILITY NAME:	FAIRWINDS - WOODWARD PARK		FACILITY NUMBER:	107201156
ADMINISTRATOR:	EDWARDS, DEANNE		FACILITY TYPE:	740
ADDRESS:	9525 N FT WASHINGTON RD		TELEPHONE:	(559) 434-6444
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	270	CENSUS: 197	DATE:	07/15/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Deanne Edwards, Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is in disrepair.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 7/15/21 at 10:30 am, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an initial 10-day complaint investigation. LPA met with Administrator (ADM) Deanne Edwards.

During the course of the investigation, LPA conducted interviews and reviewed records. Based on observations, interviews, and records review, LPA found that all work orders placed for R1 were completed or pending completion. One work order has been pending 3 weeks, but is on order for a new replacement.

The above allegation is unsubstantiated.

Exit interview conducted. A copy of this report will be emailed to Administrator Deanne Edwards at dedwards@leisurecare.com. Email sent with read receipt to confirm receipt of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Andy Xiong	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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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