107208908-10-3-2023-24-AS-BCHN-CWGNMV-20231010103547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 09/28/2023
Date Signed: 10/03/2023 12:40:48 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
07/05/2023 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20230705085754

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: 102	DATE:	09/28/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Administrator, Jennifer Fowler		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility is in disrepair.
Staff did not ensure that a resident's room is maintained at a comfortable temperature.

INVESTIGATION FINDINGS:

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On 9/28/23 Licensing Program Analyst (LPA) V Gorban visited facility stated above to deliver findings.
LPA met with Administrator (AD) Jennifer Fowler explained the purpose of the visit and discussed findings.

Allegation: Facility is in disrepair.
Allegation: Staff did not ensure that a resident's room is maintained at a comfortable temperature.

During this investigation LPA observed facility, reviewed history files, facility files, and interviewed facility staff. Based on investigation listed above these allegations are Unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview conducted, report signed and provided to AD 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: 09/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023

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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