107201156-6-22-2022-24-AS-MHON-CJVLKG-20221004084928

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107201156
Report Date: 06/22/2022
Date Signed: 06/22/2022 01:17:47 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
06/14/2022 and conducted by Evaluator Malia Thao

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220614100748

FACILITY NAME:	FAIRWINDS - WOODWARD PARK		FACILITY NUMBER:	107201156
ADMINISTRATOR:	VALERO, DESIREE		FACILITY TYPE:	740
ADDRESS:	9525 N FT WASHINGTON RD		TELEPHONE:	(559) 434-6444
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	270	CENSUS: 203	DATE:	06/22/2022
		UNANNOUNCED	TIME BEGAN:	09:16 AM
MET WITH:	Desiree Valero, Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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9

Staff did not issue a refund to resident.

INVESTIGATION FINDINGS:

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5
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13

On 6/22/22 at 9:16 AM Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint inspection. LPA checked in at front desk and met with Administrator (ADM) Desiree Valero. LPA explained reason for inspection.

LPA reviewed records and conducted interviews. Based on records review and interviews, LPA found that the facility issued the refund to R1 within 30 days as agreed upon in the admission agreement of page 5, item number 17. This agency has investigated the complaint alleging staff did not issue a refund to resident. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted. A copy of this report was given to Administrator Desiree Valero, whose signature confirms receipt of this report.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: (559) 470-9001
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2022

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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