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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206701
Report Date: 04/06/2022
Date Signed: 04/06/2022 02:58:10 PM



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
03/28/2022 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20220328091220
FACILITY NAME:VETERANS HOME OF CALIFORNIA-FRESNOFACILITY NUMBER:
107206701
ADMINISTRATOR:SCOTT H. RICHARDSFACILITY TYPE:
740
ADDRESS:2811 W. CALIFORNIA AVENUETELEPHONE:
(559) 493-4400
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY:186CENSUS: 156DATE:
04/06/2022
UNANNOUNCEDTIME BEGAN:
11:14 AM
MET WITH:Administrator, Scott RichardsTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are mistreating a resident while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This is an amended report.

On 04/06/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation at the above facility. LPA introduced self, stated the purpose of the visit and reqeusted to meet with the Administrator. LPA met with Administrator, Scott Richards.

Today's inspection included resident and staff interviews and record review.

This agency has investigated the complaint alleging: Staff are mistreating a resident while in care. We have found that the complaint was UNFOUNDED, meaning the allegation was false, could not have happened or is without a reasonable basis.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator whose signature on this form confirms receipt of this document.
Unfounded
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
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 2
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
03/28/2022 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20220328091220

FACILITY NAME:VETERANS HOME OF CALIFORNIA-FRESNOFACILITY NUMBER:
107206701
ADMINISTRATOR:SCOTT H. RICHARDSFACILITY TYPE:
740
ADDRESS:2811 W. CALIFORNIA AVENUETELEPHONE:
(559) 493-4400
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY:186CENSUS: 156DATE:
04/06/2022
UNANNOUNCEDTIME BEGAN:
11:14 AM
MET WITH:Administrator, Scott RichardsTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff interfere with the residents personal information
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 04/06/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation at the above facility. LPA introduced self, stated the purpose of the visit and reqeusted to meet with the Administrator. LPA met with Administrator, Scott Richards

Today's inspection included resident and staff interviews and record review.

This agency has investigated the complaint alleging: Staff interfere with the residents personal information. We have found that the complaint was UNFOUNDED, meaning the allegation was false, could not have happened or is without a reasonable basis.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator whose signature on this form confirms receipt of this document.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2