107203197-8-26-2020-24-AS-AXIG-BSUN3H-20200826100622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107203197
Report Date: 08/21/2020
Date Signed: 08/26/2020 08:07:21 AM

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
07/06/2020 and conducted by Evaluator See Moua

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200706161148

FACILITY NAME:	VINTAGE GARDENS		FACILITY NUMBER:	107203197
ADMINISTRATOR:	GEBBIA, LOUIS		FACILITY TYPE:	740
ADDRESS:	540 S. PEACH		TELEPHONE:	(559) 252-4036
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	158	CENSUS: 72	DATE:	08/21/2020
		UNANNOUNCED	TIME BEGAN:	09:02 AM
MET WITH:	Louis Gebbia, Administrator		TIME COMPLETED:	09:03 AM

ALLEGATION(S):

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Facility has bed bugs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) S. Moua contacted the facility on this date telephonically due to COVID-19 precautionary measures. LPA spoke with Administrator Louis Gebbia and reviewed the allegations. Findings were delivered.

LPA interviewed staff, resident, and reviewed records. Based on interviews conducted and records reviewed, the source of the bed bugs is unknown. The facility took the necessary procedures to eradicate the problem as soon as staff became aware of it. Resident was moved into a new room, the old room was cleaned and sanitized, and pest control was brought in. Pest control found no signs of bed bugs in any other part of the facility except the resident’s bedroom. There is not a preponderance of evidence to prove the alleged violation was caused by the facility or its negligence, therefore the allegation is Unsubstantiated. No deficiency was observed. Exit Interview was conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda White	TELEPHONE: (559) 650-7908
LICENSING EVALUATOR NAME: See Moua	TELEPHONE: (559) 580-6596
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2020

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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