107208983-12-23-2024-24-AS-BWHE-DCFSFU-20241230125053

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208983
Report Date: 12/23/2024
Date Signed: 12/23/2024 03:48:34 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
09/11/2024 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20240911161625

FACILITY NAME:	SUMMERFIELD OF FRESNO		FACILITY NUMBER:	107208983
ADMINISTRATOR:	GALINDO, BERONICA		FACILITY TYPE:	740
ADDRESS:	6075 N. MARKS		TELEPHONE:	(559) 446-6226
CITY:	FRESNO	STATE: CA	ZIP CODE:	93711
CAPACITY:	64	CENSUS: 41	DATE:	12/23/2024
		UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Executive Director, Beronica Galindo		TIME COMPLETED:	02:46 PM

ALLEGATION(S):

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Staff do not ensure that residents are adequately fed
Staff do not ensure that residents receive fluids (water)
Resident's toilet is in disrepair

INVESTIGATION FINDINGS:

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On 12/23/24 Licensing Program Analyst (LPA) M. Garza completed and unannounced complaint visit to deliver 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 investiagation LPA requested and reviewed documentation (Resident roster, staff roster with contact information, staff schedule for month of September 2024, physicians report for R1 and R2, pre-admission appraisals for R1 and R2, needs and assessment appraisals for R1 and R2, medication list for R1 and maintenance log for September 2024 and incontinence plan for R1 and R2), completed tours and completed interviews.

During tours of the facility (9/16/24, 10/31/24 and 12/23/24) LPA observed a 2-day perishable and 7-day non-perishable supply of food as per Title 22.

CONT...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: See Moua	TELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary Garza	TELEPHONE: 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)

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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...

Interviews conducted with residents and family members disclosed there was an adequate food source for the residents to eat. Interviews with Rps family member disclosed they were "getting enough to eat and drink" and "sometimes even too much".

During interviews with staff, residents and administration they indicated that repairs are requested and completed in a timely manner. During tour of the facility LPA observed the facility (9/16/24, 10/31/24 and 12/23/24) to be in good repair.

Although the allegations may or may not have occurred, the preponderance of evidence standard has not been met per Title 22. The allegations listed above were found to be UNSUBSTANTIATED.

No deficiencies cited during this visit. Exit interview completed with Executive Director, Beronica. A copy of this report was provided.

SUPERVISOR'S NAME: See Moua	TELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary Garza	TELEPHONE: 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)

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