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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208983
Report Date: 12/23/2024
Date Signed: 12/23/2024 03:46:52 PM

Substantiated


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
09/11/2024 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20240911161625
FACILITY NAME:SUMMERFIELD OF FRESNOFACILITY NUMBER:
107208983
ADMINISTRATOR:GALINDO, BERONICAFACILITY TYPE:
740
ADDRESS:6075 N. MARKSTELEPHONE:
(559) 446-6226
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:64CENSUS: 41DATE:
12/23/2024
UNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Executive Director, Beronica GalindoTIME COMPLETED:
02:46 PM
ALLEGATION(S):
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Staff do not meet residents diapering needs
INVESTIGATION FINDINGS:
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On 12/23/24 Licensing Program Analyst (LPA) M. Garza arrived unannounced to deliver complaint findings. LPA met with Executive Director, Beronica Galindo, explained reason for visit and was permitted entry into the facility. LPA completed a health and safety check on residents in care. Residents observed in common areas and in rooms.

During the investigation documentation was reviewed (physicians reports, pre-admission appraisals, needs and services plans, hospice care plans, central stored medication logs, MARS, staff schedules, staff trainings, employment records, emergency contact information, admission agreement, hospital records, special incident reports, resident and staff roster), tours completed (9/10/24, 9/16/24 and 10/30/24) and interviews were conducted.

Based on records reviewed, pictures observed, tours completed and interviews conducted with staff and family the information indicates personal care needs (incontinence, grooming, bathing) are not being met.

CONT...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
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 2
Control Number 24-AS-20240911161625
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: SUMMERFIELD OF FRESNO
FACILITY NUMBER: 107208983
VISIT DATE: 12/23/2024
NARRATIVE
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CONT...

The above allegation met the preponderance of evidence standard per Title 22. During previous complaint visit on 12/20/24 (Complaint #24-AS-20240906130954) findings were delivered on this allegation.

Deficiencies were not cited during this visit. Exit interview completed with Executive Director, Beronica. A copy of this report and appeal rights provided.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2