107208908-11-3-2021-24-AS-MHON-C8GLXK-20211105090848

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208908
Report Date: 11/03/2021
Date Signed: 11/03/2021 01:54:14 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
08/20/2021 and conducted by Evaluator Alexandria Walton

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20210820151154

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:	DATE:	11/03/2021
		UNANNOUNCED	TIME BEGAN:	12:19 PM
MET WITH:	Executive Director, Pamela Hamilton		TIME COMPLETED:	01:10 PM

ALLEGATION(S):

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Staff are not wearing masks

INVESTIGATION FINDINGS:

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On 11/03/2021, Licensing Program Analyst (LPA) A. Walton arrived unannounced to conduct a subsequent complaint investigation at the above faciltiy. LPA introduced self, stated the purpose of the visit and requested to meet with the Executive Director (ED). LPA met with ED, Pamela Hamilton and Resident Service Director (RSD), Olaf Becker.

During today's visit, LPA conducted a facility tour with ED and RSD. During the facility tour, LPA observed DS1 to be wearing a facial covering improperly. DS2 and DS3 were observed to not be wearing facial coverings. Front desk staff and care providers were observed to be wearing facial coverings during this inspection.

Based on observation, the facility failed to protect the personal rights of clients in care to receive safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of clients in care...

CONTINUED TO LIC9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021

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-20210820151154

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: 11/03/2021

NARRATIVE

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in that 3 out 4 dining room staff were observed to be not wearing facial coverings and wearing facial coverings improperly in violation of official government orders requiring the wearing of face coverings while working under specified conditions.

A deficiency is being cited in accordance with the California Code of Regulations, Title 22, Division 6, Chapter 8, Section 87468.1.

An exit interview was conducted and a Plan of Correction was reviewed and developed with Executive Director. A copy of this report and Appeal Rights were provided via email and an electronic read receipt confirms receiving these documents. Facility Representative signature on file.

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021

LIC9099 (FAS) - (06/04)

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Control Number 24-AS-20210820151154

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: 11/03/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/03/2021 Section Cited CCR 87468.1(a)(2)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities (a)(2): Residents... shall have all of the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will submit a plan detailing steps the facility will take to ensure staff wear face masks while in the facility as mandated, by 12/03/2021.
	8 9 10 11 12 13 14	Based on observation, the facility did not ensure staff are wearing facial coverings as mandated when it was observed that 3 out of 4 dining staff were not wearing facial coverings during the lunch period. This poses a potential health and safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 11/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021

LIC9099 (FAS) - (06/04)

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