<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208838
Report Date: 10/18/2024
Date Signed: 10/18/2024 02:05:14 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
05/29/2024 and conducted by Evaluator Melinda Medina
COMPLAINT CONTROL NUMBER: 24-AS-20240529155053
FACILITY NAME:MAGNOLIA CROSSINGFACILITY NUMBER:
107208838
ADMINISTRATOR:PETERS, CONSTANCEFACILITY TYPE:
740
ADDRESS:32 W SIERRA AVETELEPHONE:
(559) 765-4916
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY:60CENSUS: 43DATE:
10/18/2024
UNANNOUNCEDTIME BEGAN:
08:48 AM
MET WITH:Constance PetersTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff neglect resulted in a resident sustaining a fracture while in care
Staff are mishandling the residents medications
Staff are inappropriately administering the residents medications
Staff did not properly report incidents involving the residents
Staff are not being properly trained
Staff did not provide adequate care and supervision to the residents
Staff did not prevent the residents from engaging in an altercation
Staff do not respond timely to the resident alerts
Staff did not seek timely medical attention for a resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/18/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to conduct interviews and deliver findings. LPA introduced self, stated purpose of visit, and met with Administrator, Constance Peters.

This department investigated the above allegations during the investigation, LPA toured facility, conducted interviews, and reviewed records. This department had insufficient information regarding the allegations listed above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or disprove that the allegations occurred therefore the allegations are UNSUBSTANTIATED.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
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
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
05/29/2024 and conducted by Evaluator Melinda Medina
COMPLAINT CONTROL NUMBER: 24-AS-20240529155053

FACILITY NAME:MAGNOLIA CROSSINGFACILITY NUMBER:
107208838
ADMINISTRATOR:PETERS, CONSTANCEFACILITY TYPE:
740
ADDRESS:32 W SIERRA AVETELEPHONE:
(559) 765-4916
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY:60CENSUS: 43DATE:
10/18/2024
UNANNOUNCEDTIME BEGAN:
08:48 AM
MET WITH:Constance PetersTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not keep the facility free from pests
Staff do not properly maintain the facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/18/24, Licensing Program Analyst (LPA) M. Medina conducted a subsequent unannounced complaint visit to conduct interviews and deliver findings. LPA introduced self, stated purpose of visit, and met with Administrator, Constance Peters.

During course of the investigation, facility was toured, records reviewed, and interviews conducted. This department investigated the allegation of staff do not keep the facility free from pests and staff do not properly maintain the facility. During record review, LPA was provided with monthly pest control service records, and documentation to support interminent service as needed. During facility tour of inside of buildings, LPA observed buildings to be clean, odor free, and a comfortable temperature. Outside of facility appeared to be well maintained, free of hazards and exits observed unobstructed.

This Department has found that the above allegations are UNFOUNDED, meaning they were false, could not have happened, and/or were without reasonable basis. We have therefore dismissed the complaint.

No deficiencies cited.

Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2