107208838-5-31-2023-24-AS-MHON-CV7UVP-20230830155528

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208838
Report Date: 05/31/2023
Date Signed: 05/31/2023 10:21:06 AM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
05/25/2023 and conducted by Evaluator Malia Thao

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20230525082016

FACILITY NAME:	MAGNOLIA CROSSING		FACILITY NUMBER:	107208838
ADMINISTRATOR:	RANCOUR, MANDY		FACILITY TYPE:	740
ADDRESS:	32 W SIERRA AVE		TELEPHONE:	(559) 765-4916
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93612
CAPACITY:	60	CENSUS: 39	DATE:	05/31/2023
		UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Constance Peters, Administrator		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Staff did not ensure facility ovens are working properly

INVESTIGATION FINDINGS:

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On 5/31/23 at 8:20 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an initial 10-day complaint inspection. LPA explained reason for inspection and was granted entry by Administrator (ADM) Constance Peters.

LPA conducted interviews and toured the three buildings. LPA observed each building with a kitchen that has a double oven. LPA observed all six ovens operational and heating up. The allegation is false, could not have happened, and/or is without a reasonable basis.

Exit interview conducted. A copy of this report was given to Administrator, whose signature confirms receipt of this report.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) -341-3274
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: 559-470-9001
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

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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