107208908-2-4-2024-24-AS-BCHN-D35TTJ-20240307140048

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 02/01/2024
Date Signed: 02/04/2024 05:10:59 AM

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
11/03/2023 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20231103105434

FACILITY NAME:	WESTMONT OF FRESNO		FACILITY NUMBER:	107208908
ADMINISTRATOR:	FRAZIER, PATRICK		FACILITY TYPE:	740
ADDRESS:	7442 & 7468 N MILLBROOK AVE		TELEPHONE:	(559) 446-1266
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	155	CENSUS: 73	DATE:	02/01/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Administrator, Eddie Rangel		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff are allowing residents to share hygiene products
Staff are allowing the residents to share clothes while in care
Staff are disclosing the residents personal information
Staff are not providing adequate supervision to the residents while in care

INVESTIGATION FINDINGS:

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On 2/01/24, LPA Gorban visited the facility to deliver the findings. During this visit LPA met with facility Administrator (AD) Eddie Rangel and stated the purpose of the visit.

During this visit LPA toured facility inside and pout and observed residents in care.
Once the tour was complete, LPA discussed finding with the AD.

Allegations: Staff are allowing residents to share hygiene products. Staff are allowing the residents to share clothes while in care. Staff are disclosing the residents personal information. Staff are not providing adequate supervision to the residents while in care. During complaint investigation department reviewed facility records, interviewed facility staff and Administrator. Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.
Report continues on LIC9099-A

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: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

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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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
11/03/2023 and conducted by Evaluator Vadim Gorban

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20231103105434

FACILITY NAME:	WESTMONT OF FRESNO		FACILITY NUMBER:	107208908
ADMINISTRATOR:	FRAZIER, PATRICK		FACILITY TYPE:	740
ADDRESS:	7442 & 7468 N MILLBROOK AVE		TELEPHONE:	(559) 446-1266
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	155	CENSUS: 73	DATE:	02/01/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Administrator, Eddie Rangel		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff are mishandling the residents medications
Staff are not properly reporting incidents involving the residents

INVESTIGATION FINDINGS:

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Allegation: Staff are mishandling the residents medications.
During investigation the facility files were reviewed. It was discovered during file review that facility in violation of Title 22, Incidental Medical and Dental . Deficiencies are being cited in accordance with California Code of Regulations on the attached LIC 9099-D in the areas of Incidental Medical.

Allegation: Staff are not properly reporting incidents involving the residents.
During file review appeared that the facility did not follow title 22 reporting requirements. Based on record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.

Exit interview conduced, report signed and copy of this report with Appeal Rights provided to Administrator for facility records.

Substantiated

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: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

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-20231103105434

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: WESTMONT OF FRESNO	FACILITY NUMBER: 107208908
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/01/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/02/2024 Section Cited CCR 87465(c)(2)	1 2 3 4 5 6 7	87465 (c)(2) Incidental Medical and Dental Care. Once ordered by the physician the medication is given according to the physician's directions. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	AD will provide as a POA during inservice training for the facility staff on 2/01/24 and once complete, will provide a written statement to LPA by 2/02/2024 by email.
	8 9 10 11 12 13 14	Facility failed to administer mediations as prescribed and acording to physician directions. This poses an immediate risk to health and safety to residents in care.	8 9 10 11 12 13 14
Type B 02/05/2024 Section Cited CCR 87211(a)(1)	1 2 3 4 5 6 7	87211 Reporting Requirements (a)(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of occurence. This requirement was not met as evicencd by:	1 2 3 4 5 6 7	AD will provide a staff trainig and education during the facility inservice training on reporting requirements following Title 22 accordingly and in timely manner.
	8 9 10 11 12 13 14	The acility failed to provide a report to Licensing Agency following the title 22 gegulation in timely manner. This poses potentia risk to health and safety to residents in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: Vadim Gorban	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

LIC9099 (FAS) - (06/04)

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