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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206809
Report Date: 11/02/2024
Date Signed: 11/03/2024 08:45:50 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
07/30/2024 and conducted by Evaluator Lisa Salazar
COMPLAINT CONTROL NUMBER: 24-AS-20240730093823
FACILITY NAME:EDWARDS TENDER LOVING CARE & MOREFACILITY NUMBER:
107206809
ADMINISTRATOR:EDWARDS, LAURAFACILITY TYPE:
740
ADDRESS:6775 W STUART AVETELEPHONE:
(559) 515-6458
CITY:FRESNOSTATE: CAZIP CODE:
93723
CAPACITY:6CENSUS: 4DATE:
11/02/2024
UNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Maria Avila, CaregiverTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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9
Staff are mishandling the residents medications
Staff have expired food for the residents.
Staff are using a manual locks for the exit doors
INVESTIGATION FINDINGS:
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On 11/12/24, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to deliver findings on the above allegations. LPA was greeted by caregiver, stated the purpose of the visit and was allowed entry into the facility. LPA called Licensee/Administrator to discuss findings over the phone however, Licensee/ Administrator was unavailable.

During the investigation, LPA conducted a facility tour, reviewed records and conducted interviews. Based on the information received, medications were observed to be stored and documented according to physician's orders. A 7-day supply of non perishable's and a 2-day supply of perishables were observed to be in good quality and quantity. Manual locks were not observed being used and were removed on 08/06/24.

Although the allegations may have happened, there is not a preponderance of evidence to prove that the alleged violations occurred, therefore the allegations are Unsubstantiated. No deficiencies cited.

An exit interview was conducted with Licensee/Administrator via telephone. Licensee/Administrator gave staff permission to sign report and a report will be sent via email by next business day, with a read receipt as proof of delivery.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa SalazarTELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2024
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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