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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107203515
Report Date: 04/27/2022
Date Signed: 04/27/2022 04:56:53 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
04/18/2022 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20220418134547
FACILITY NAME:RUBY'S VALLEY CARE HOMEFACILITY NUMBER:
107203515
ADMINISTRATOR:ANTHONY BEASLEYFACILITY TYPE:
735
ADDRESS:9919 SOUTH ELM AVE.TELEPHONE:
(559) 834-6038
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY:50CENSUS: 45DATE:
04/27/2022
UNANNOUNCEDTIME BEGAN:
04:26 PM
MET WITH:Assistant Administrator, Anthony BeasleyTIME COMPLETED:
05:12 PM
ALLEGATION(S):
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Staff do not provide appropriate laundry services to resident in care
INVESTIGATION FINDINGS:
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On 04/27/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Assistant Administrator, Anthony Beasley.

LPA conducted a facility tour, reviewed records, and interviewed staff and residents.

Interviews revealed that staff will notify the Administrator and the resident when resident clothing is damaged in the laundry. Per Administrator, the facility will contact the resident's county to assist in purchasing new clothing to replace the clothing that was damaged. Faciltiy will also work with the residents to purchase new clothing if the resident has funds. Residents are allowed to assist in washing personal clothing. Some residents will assist in washing clothing, while other residents prefer for the facility housekeeping staff to wash clothing.

Continued to 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 24-AS-20220418134547
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: RUBY'S VALLEY CARE HOME
FACILITY NUMBER: 107203515
VISIT DATE: 04/27/2022
NARRATIVE
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Based on interviews conducted with staff and residents, the allegation: Staff do not provide appropriate laundry services to resident in care is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies issued during this inspection.

An exit interview was conducted with Assistant Administrator. A copy of this report was discussed and provided to Assistant Administrator, Anthony Beasley, whose signature on this form confirms receipt of this document.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3