107208908-6-18-2020-24-AS-MHON-BQUPSR-20200623113442

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 06/18/2020
Date Signed: 06/18/2020 09:42:48 AM

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
03/06/2020 and conducted by Evaluator Alexandria Walton

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200306162127

FACILITY NAME:	WESTMONT OF FRESNO		FACILITY NUMBER:	107208908
ADMINISTRATOR:	HAMILTON, PAMELA		FACILITY TYPE:	740
ADDRESS:	7442 & 7468 N MILLBROOK AVE		TELEPHONE:	(858) 729-6720
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	155	CENSUS: 67	DATE:	06/18/2020
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Executive Director, Pamela Hamilton		TIME COMPLETED:	09:40 AM

ALLEGATION(S):

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Staff did not assist resident w/ hygiene needs
Staff did not ensure resident was fed.

INVESTIGATION FINDINGS:

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On 06/18/2020 at 8:44 AM, Licensing Program Analyst (LPA) A. Walton contacted Executive Director (ED), Pamela Hamilton to deliver findings on the above allegation via telephone due to COVID-19 and precautionary measures. LPA introduced self and stated the purpose of the call.

LPA conducted interviews and reviewed records.

Interview with staff revealed that resident R1 refuses to eat some meals on some days and refuses to shower on some days due to resident's diagnosis. Staff continue to "pursue" showering resident and continue to offer meals and snacks. Resident R1's Responsible Party also contributes to assisting resident R1 with hygiene needs and ensuring resident is fed.
Continued to LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Andy Xiong	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020

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-20200306162127

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: WESTMONT OF FRESNO	FACILITY NUMBER: 107208908
	VISIT DATE: 06/18/2020

NARRATIVE

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Based on interviews conducted with staff and responsible party, the allegations: Staff did not assist resident with hygiene needs and Staff did not ensure resident was fed are UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies issued during today's inspection.

An exit interview was conducted with ED. A copy of this report discussed and provided to Executive Director, Pamela Hamilton via email and an electronic read receipt confirms receiving these documents.

SUPERVISOR'S NAME: Andy Xiong	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2020

LIC9099 (FAS) - (06/04)

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