107208908-7-28-2023-24-AS-BCHN-CU9S9A-20230731134025

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 07/05/2023
Date Signed: 07/28/2023 12:11:25 PM

Unsubstantiated

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
04/04/2023 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20230404100407

FACILITY NAME:	WESTMONT OF FRESNO		FACILITY NUMBER:	107208908
ADMINISTRATOR:	ERIK V. SCHUK		FACILITY TYPE:	740
ADDRESS:	7442 & 7468 N MILLBROOK AVE		TELEPHONE:	(559) 446-1266
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	155	CENSUS: 140	DATE:	07/05/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Michelle Gonzalez, RSD		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff did not assist resident in a timely manner

INVESTIGATION FINDINGS:

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This document is amended of the original report.
On 7/05/23, Licensing Program Analyst (LPA) V Gorban conducted the subsequent complaint investigation visit to the facility. LPA met with Residents Services Director (RSD), Michelle Gonzalez, explained the purpose of the visit and discussed allegation findings. Administrator Erik Schuk was not available.

Allegation: Facility staff did not assist resident in a timely manner

During the course of investigation, observation, records reviews and interviews, this allegation is 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, therefore the allegation is unsubstantiated.

Exit interview conducted with RSD. Copy of this report signed and provided for facility records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Vadim Gorban	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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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