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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 03/23/2021
Date Signed: 03/23/2021 01:45:09 PM



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
10/01/2020 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20201001090447
FACILITY NAME:WESTMONT OF FRESNOFACILITY NUMBER:
107208908
ADMINISTRATOR:HAMILTON, PAMELAFACILITY TYPE:
740
ADDRESS:7442 & 7468 N MILLBROOK AVETELEPHONE:
(858) 729-6720
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:155CENSUS: DATE:
03/23/2021
UNANNOUNCEDTIME BEGAN:
01:22 PM
MET WITH:Executive Director, Pamela HamiltonTIME COMPLETED:
01:23 PM
ALLEGATION(S):
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Illegal eviction
INVESTIGATION FINDINGS:
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On 3/23/2021, Licensing Program Analyst (LPA) A. Walton contacted Executive Director (ED), Pamela Hamilton to conduct a subsequent complaint investigation via telephone due to COVID-19 and precautionary measures. The purpose of today’s investigation is to deliver findings on the above allegation.

During the course of the investigation, LPA conducted staff interviews and reviewed records for R1. Interviews with staff revealed that a second needs and services appraisal was not conducted for R1 and a 30 day Eviction notice was not issued to R1 or the Responsible Party.

Based on review of R1’s records and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

CONTINUED TO LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 24-AS-20201001090447
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: 03/23/2021
NARRATIVE
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 A deficiency is being cited on the attached 9099D in accordance to California Code of Regulations, Title 22, Division 6, Section 87224(a)(4).

A Plan of Correction was developed and reviewed with ED. Exit interview conducted. A copy of this report and Appeal Rights were discussed and provided to ED via email and an electronic read receipt confirms receiving these documents. Facility Representative signature on file.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20201001090447
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/02/2021
Section Cited
CCR
87224(a)(4)
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87224 Eviction Procedures(a)(4): The licensee may evict a resident…Thirty (30) days written notice to the resident is required (4) If…it is determined that the resident has a need not previously identified and a...
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Licensee agreed to review Section 87224, Eviction Procedures and will submit a statement detailing how the facility will adhere to the regulation.
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reappraisal has been conducted. This requirement was not met as evidenced by: Based on record review and interviews, the facility failed to legally evict R1 when the facility did not conduct a reappraisal on R1 and did not provide a Thirty (30) day written notice to R1. This poses a potential health and safety risk to R1.
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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: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2021
LIC9099 (FAS) - (06/04)
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