107208838-2-6-2024-24-AS-SPIY-D2HM8V-20240216082345

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208838
Report Date: 02/06/2024
Date Signed: 02/06/2024 02:09:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
12/01/2023 and conducted by Evaluator Miriam Flores

COMPLAINT CONTROL NUMBER: 24-AS-20231201155005

FACILITY NAME:	MAGNOLIA CROSSING		FACILITY NUMBER:	107208838
ADMINISTRATOR:	PETERS, CONSTANCE		FACILITY TYPE:	740
ADDRESS:	32 W SIERRA AVE		TELEPHONE:	(559) 765-4916
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93612
CAPACITY:	60	CENSUS: 44	DATE:	02/06/2024
		UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Constance Peters		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Staff handle resident in a rough manner
Staff emotionally abuses resident
Staff do not assist resident with ambulating
Staff do not assist resident with personal care
Staff do not assist resident with incontinence needs
Staff spoke inappropriately to resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) M. Flores arrived at the facility unannounced to deliver findings on this investigation. LPA met with Facility Administrator, Constance Peters and announced the purpose of the visit.

LPA conducted interviews, observations, and record reviews.

Regarding staff handling residents in a rough manner, LPA interview four residents. Three of the four residents reported they have not seen or heard staff handle residents in a rough manner. One resident reported hearing from other residents that residents are handled in a rough manner.

Continue 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) -24-0610
LICENSING EVALUATOR NAME: Miriam Flores	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

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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Control Number 24-AS-20231201155005

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: MAGNOLIA CROSSING	FACILITY NUMBER: 107208838
	VISIT DATE: 02/06/2024

NARRATIVE

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Regarding staff emotionally abusing residents, LPA interviewed four resident assistants who all denied hearing or witnessing staff emotionally abusing residents. Four of the residents also denied hearing or witnessing emotional abuse from staff.

Regarding staff not assisting resident with ambulating. Interviews conducted with staff, staff reported that they did not witness or heard staff denying assistance to residents with ambulating. Half of the residents reported that they have not heard or witnessed staff not assisting residents with ambulating. The other half of the residents interviewed; it was reported that they have only heard from other residents that some staff do not assist residents with ambulating timely.

Regarding staff not assisting residents with personal care, LPA conducted eight interviews between residents and resident assistants. All parties interviewed denied hearing or witnessing staff not assisting residents with their personal care.

Regarding staff not assisting resident with incontinence needs, LPA conducted eight interviews between residents and resident assistants; All parties interviewed denied hearing or witnessing staff not assisting residents with incontinence needs.

Regarding to staff speaking inappropriately to residents, LPA conducted eight interviews between residents and resident assistants. All parties interviewed denied hearing or witnessing staff speaking inappropriate to residents. It was shared by one of the residents that they witnessed a resident speak inappropriate to staff.

The Department has investigated the above allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No Deficiencies are being cited Per Title 22 Regulations. Exit interview conducted with Facility Administrator, Constance Peters. A copy of this report was provided to the Administrator, along with the appeals rights.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) -24-0610
LICENSING EVALUATOR NAME: Miriam Flores	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2024

LIC9099 (FAS) - (06/04)

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