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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107203958
Report Date: 12/20/2022
Date Signed: 12/20/2022 09:24:59 AM

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
12/12/2022 and conducted by Evaluator Lady Cabrera
COMPLAINT CONTROL NUMBER: 24-AS-20221212141313
FACILITY NAME:SERENITY LIVING IIFACILITY NUMBER:
107203958
ADMINISTRATOR:JOSIANE P JONESFACILITY TYPE:
740
ADDRESS:1770 W. SAN JOSE AVENUETELEPHONE:
(559) 436-0211
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: DATE:
12/20/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Josiane P Jones, AdministratorTIME COMPLETED:
09:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are allowing drug dealing from facility.
Licensee is operating out of the scope of license.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this date, Licensing Program Analyst (LPA) L. Cabrera and, Regional Manager Brenda White (LPM) and Licensing Program Manager (LPM) S. Moua met with Licensee/Administrator Josiane P Jones and Elaine Sauceda to discuss and deliver findings for the above allegations.

Based on interviews conducted, it was confirmed that the property was sold on 10/12/2022 and the licensee forfeited her license. The property is currently operating as a Room and Board Transitional Living. The individuals occupying the room are independent and do not require care and supervision. The complaint is Unfounded.

Exit Interview conducted.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lady CabreraTELEPHONE: (559) 513-9832
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2022
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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