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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206701
Report Date: 01/25/2024
Date Signed: 01/25/2024 10:33:36 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
01/22/2024 and conducted by Evaluator Alexandria Walton
COMPLAINT CONTROL NUMBER: 24-AS-20240122185814
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: 126DATE:
01/25/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator, Scott Richards and Supervising Registered Nurse Priscilla MedinaTIME COMPLETED:
10:48 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility does not provide a safe environment for a resident
Facility is retaining a resident requiring a higher level of care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 01/25/2024, 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 Adminitrator. LPA met with Administrator, Scott Richards and Supervising Registered Nurse Priscilla Medina.

During today's visit, LPA reviewed records and conducted interviews and found that the facility has increased monitoring for R1 and are in the process of accessing R1 for a higher level of care. Based on interviews and record review, the allegations: Facility does not provide a safe environment for a resident and Facility is retaining a resident requiring a higher level of care are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Scott Richards, whose signature on this form confirms receipt of this document.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
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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