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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208983
Report Date: 07/18/2026
Date Signed: 07/18/2026 12:50:54 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
11/18/2025 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20251118140904
FACILITY NAME:SUMMERFIELD OF FRESNOFACILITY NUMBER:
107208983
ADMINISTRATOR:HUNTLEY, ROBERTFACILITY TYPE:
740
ADDRESS:6075 N. MARKSTELEPHONE:
(559) 446-6226
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:64CENSUS: 48DATE:
07/18/2026
UNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Executive Director, Sheree AddisonTIME COMPLETED:
12:48 PM
ALLEGATION(S):
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Untrained staff administering medication to residents
Staff are mismanaging residents medication
Staff did not prevent resident from wandering from the facility
INVESTIGATION FINDINGS:
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On 07/18/26 Licensing Program Analyst, M. Garza arrived at the facility for an unannounced to deliver findings on a complaint. LPA met with Receptionist, Brenda Ruvalcaba explained reason for visit and was permitted entry into the facility. Executive Director (ED), Sheree Addison was contacted and arrived some time later. LPA toured the facility and completed a health and safety check on residents in care.

During complaint LPA completed tours, interviews, requested and reviewed documentation.

Allegation: Untrained staff administering medication to residents
Interviews were conducted and records reviewed. Interviews disclosed the activities staff was passing medication without the proper training. Review of records disclosed the activities staff did not have the required initial and ongoing training required to provide medications to the residents.

CONT...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026
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 5
Control Number 24-AS-20251118140904
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: 07/18/2026
NARRATIVE
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CONT...

Allegation: Staff are mismanaging residents medication
LPA observation of the medical technician- during medication pass the medical technician was observed transferring medication from one container to another for several residents and signing prior to providing and verifying medications were taken by the resident. Pictures provided and interviews conducted disclosed medications were being found in resident rooms and on the floors of the facility after medications were given.

Allegation: Staff did not prevent resident from wandering from the facility
Interviews conducted and special incident reports were reviewed. During interviews it was disclosed R1 walked away from the facility on at least 2 separate occasions. Fresno PD returned R1 to the facility on 1 occasion. Review of special incident reports provided to the department shows the facility did not report these incidents.

The allegations listed above are SUBSTANTIATED. The preponderance of evidence standard has been met per California Code of Regulations, Title 22. Deficiencies cited on 9099D. If not corrected, deficiencies have a direct impact to residents in care. ****Immediate civil penalty in the amount of $500 assessed****

Exit interview completed with ED, Sheree. A plan of correction was provided by ED and reviewed by LPA. A copy of this report provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 24-AS-20251118140904
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/20/2026
Section Cited
CCR
87411(d)(4)
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87411 Personnel Requirements – General (d) All personnel shall be given on the job training or have related experience in the job assigned to them... (4) Knowledge required to safely assist with prescribed medications which are self-administered.
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ED stated staff observed is no longer working at the facility. Resident Care Director that was allowing this to occur is no longer working at the facility as well. In-service sign in sheet and training material will be provided to CCL as proof of correction.
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This requirement was not met as evidence by: interviews conducted and records reviewed. Interviews disclosed an untrained staff was providing medication. This poses an immediate health safety and or personal rights risk to residents in care.
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Type A
07/20/2026
Section Cited
CCR
87411(a)
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87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.
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ED stated medical technician has been retrained and will provide documentation of this training to CCL as proof of correction.
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This requirement was not met by: LPA observation of the medical technician- during medication pass the medical technician was observed transferring medication from one container to another for several residents and signing prior to providing and verifying medications were taken by the resident. Pictures provided and interviews conducted disclosed medications were being found in resident rooms and on the floors of the facility after med pass. This poses an immediate health safety and or personal right risk to residents in care.
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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: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 24-AS-20251118140904
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/20/2026
Section Cited
CCR
87705(5)
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87705 Care of Persons with Dementia (5) Facility staff shall ensure the continued safety of residents if they wander away from the facility...
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ED stated they have increase elopement drills for all three shifts. Documentation of the drills will be provided to CCL as proof of correction.
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This requirement was not met as evidence by: interview conducted and records reviewed. Licensee did not comply with the section cited above in that R1 wandered from the facility and without staff ensuring continued safety and being returned by law enforcement. This poses an immediate health safety and or personal rights risk to residents in care. *****Immediate civil penalty in the amount of $500 assessed.*****
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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: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5
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
11/18/2025 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20251118140904

FACILITY NAME:SUMMERFIELD OF FRESNOFACILITY NUMBER:
107208983
ADMINISTRATOR:HUNTLEY, ROBERTFACILITY TYPE:
740
ADDRESS:6075 N. MARKSTELEPHONE:
(559) 446-6226
CITY:FRESNOSTATE:CAZIP CODE:
93711
CAPACITY:64CENSUS: 48DATE:
07/18/2026
UNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Executive Director, Sheree AddisonTIME COMPLETED:
12:48 PM
ALLEGATION(S):
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Staff did not prevent resident from physically abusing other residents resulting in injuries
Staff handled resident in a rough manner
Staff are not meeting residents dressing needs
Staff are not providing comfortable bedding accommodations for resident
INVESTIGATION FINDINGS:
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On 07/18/26 Licensing Program Analyst, M. Garza arrived at the facility for an unannounced to deliver findings on a complaint. LPA met with Receptionist, Brenda Ruvalcaba explained reason for visit and was permitted entry into the facility. Admniistrator was contacted and arrived some time later. LPA toured the facility and completed a health and safety check on residents in care.

During complaint LPA completed tours, interviews and reviewed documentation. Interviews and documentation did not support the allegations listed above. Although the allegations listed above may or may not have occurred, the preponderance of evidence standard has not been met per California Code of Regulations, Title 22. The allegations listed above are UNSUBSTANITATED. No deficiencies cited during today’s visit.

Exit interview conducted with Executive Director, Sheree. A copy of this report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5