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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206939
Report Date: 09/11/2025
Date Signed: 09/11/2025 05:21:56 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
09/02/2025 and conducted by Evaluator Katie Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250902090350
FACILITY NAME:KINGSTON BAY SENIOR LIVINGFACILITY NUMBER:
107206939
ADMINISTRATOR:DENNIS, SARAHFACILITY TYPE:
740
ADDRESS:6161 W SPRUCE AVETELEPHONE:
(559) 479-4700
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:128CENSUS: 91DATE:
09/11/2025
UNANNOUNCEDTIME BEGAN:
10:17 AM
MET WITH:Sarah DennisTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff did not maintain a comfortable temperature for residents in care
Staff are not following the facility menu
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the initial complaint visit. LPA met with and explained the reason for the visit and reviewed the allegations with Administrator (AD) Sarah Dennis and Director of Nursing (DON) Jami Young, LVN.

During the visit, LPA conducted interviews, record reviews, observed lunch service and toured the kitchen.

This Department investigated the allegations noted above. Interviews with AD and DON reveal that each resident has 1-2 Air conditioning units in their apartments. Residents reported their rooms being maintained at a comfortable temperature and if there is an issue, a work order can be made at the front desk. A record review was conducted of the work order log. There are work order entries "AC not working" that are "open" ranging from 1-7 days. In multiple apartments toured, the resident did not have the thermostat set correctly or even set to on.

See LIC 9099C for Continuation of this report
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025
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
Control Number 24-AS-20250902090350
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: KINGSTON BAY SENIOR LIVING
FACILITY NUMBER: 107206939
VISIT DATE: 09/11/2025
NARRATIVE
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This Department investigated the allegation: Staff are not following the facility menu. The facility has a set "restaurant style" menu listing meal options as well as offering daily specials for lunch and dinner. Residents consistently reported that there are times when they have run out of the daily special, specific side dishes or a preferred menu item. Residents also report that an alternative meal or item is always available. Based on interview, there are times when ordered items are not delivered and adjustments to the menu need to be made.

Based on interview, observation and record review the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur.

There were no citations issued. An exit interview was conducted and a copy of this report was provided.Document Link Icon
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2