107203215-5-5-2022-24-AS-MHON-CF2RYK-20220603132628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107203215
Report Date: 05/05/2022
Date Signed: 05/05/2022 10:19:24 AM

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
04/15/2022 and conducted by Evaluator Mai Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220415124148

FACILITY NAME:	ROYAL CARE		FACILITY NUMBER:	107203215
ADMINISTRATOR:	RIGON, RUDY G.		FACILITY TYPE:	740
ADDRESS:	2768 PURVIS AVE.		TELEPHONE:	(559) 324-8792
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY:	6	CENSUS: 3	DATE:	05/05/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Assistant Administrator, Aurora Rigon		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility staff verbally abuses resident(s) while in care.

INVESTIGATION FINDINGS:

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On 05/05/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver finding on the above allegation. LPA introduced self, stated the purpose of the visit, and met with Assistant Administrator Aurora Rigon.

During the course of the investigation, the Department conducted interviews with staff and residents. Residents were not verbally abuse by facility staff while in care.

Based on interviews which were conducted, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to Assistant Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai Yang	TELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022

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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