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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107202784
Report Date: 04/22/2022
Date Signed: 04/22/2022 01:10:13 PM

Unsubstantiated


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
09/13/2021 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210913112925
FACILITY NAME:OHANNESIAN HOME #2FACILITY NUMBER:
107202784
ADMINISTRATOR:MATTHEW, VERONICAFACILITY TYPE:
735
ADDRESS:10650 SO. FRANKWOOD AVENUETELEPHONE:
(559) 255-3609
CITY:REEDLEYSTATE: CAZIP CODE:
93654
CAPACITY:6CENSUS: 4DATE:
04/22/2022
UNANNOUNCEDTIME BEGAN:
11:59 AM
MET WITH:Veronica MatthewTIME COMPLETED:
01:24 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff handled resident in a rough manor
Staff does not treat resident with respect
Resident had inappropriate interaction with another resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) M. Medina conducted a subsequent visit to facility to investigate complaint. LPA identified herself and discussed the purpose of visit with Administrator, Veronica Matthew.

LPA conducted interviews, and reviewed documentation received during complaint investigation. Based on interviews, and record reviews, there was insufficient evidence that staff handled resident in a rough manor, staff does not treat resident with respect, and resident had inappropriate interaction with another resident.

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 allegations are UNSUBSTANTIATED.

Exit interview conducted. No deficiencies cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2022
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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