107206939-3-12-2026-24-AS-SDOE-DUC2XS-20260522174736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107206939
Report Date: 03/12/2026
Date Signed: 03/12/2026 04:20:23 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
03/04/2026 and conducted by Evaluator Katie Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20260304165716

FACILITY NAME:	KINGSTON BAY SENIOR LIVING		FACILITY NUMBER:	107206939
ADMINISTRATOR:	DENNIS, SARAH		FACILITY TYPE:	740
ADDRESS:	6161 W SPRUCE AVE		TELEPHONE:	(559) 479-4700
CITY:	FRESNO	STATE: CA	ZIP CODE:	93722
CAPACITY:	128	CENSUS: 94	DATE:	03/12/2026
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Alexis Alvarez		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff do not address resident falls

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Katie Brown arrived at the facility unannounced to conduct the initial complaint investigation. LPA Met with and discussed the allegations with Administrator (AD) Alexis Alvarez and Director fo Nursing (DON) Jamie Young.

During this visit, LPA conducted inverviews and record review of Staff (S1) employee file. LPA was provided copies of facility documents for review as requested.

This Department investigated the allegation above. The Reporting Party (RP) did not provide the name(s) of residents who have fallen or incident date(s). Interview with DON did not reveal or confirm a resident(s). The facility has fall procedures in place and staff have received training. Based on interview 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 violation did or did not occur.

There were no citations issued. An exit interview was conducted and a copy of this report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2026

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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