107208989-8-25-2022-24-AS-MHON-CHUVJH-20220901162845

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208989
Report Date: 08/25/2022
Date Signed: 08/25/2022 12:41:39 PM

Unfounded

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
08/19/2022 and conducted by Evaluator Alexandria Walton

COMPLAINT CONTROL NUMBER: 24-AS-20220819111313

FACILITY NAME:	BELLA CARE HOME LLC-MATUS		FACILITY NUMBER:	107208989
ADMINISTRATOR:	GONZALES, MARILEN		FACILITY TYPE:	740
ADDRESS:	7947 NORTH MATUS AVE		TELEPHONE:	(559) 259-6228
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	6	CENSUS: 6	DATE:	08/25/2022
		UNANNOUNCED	TIME BEGAN:	12:04 PM
MET WITH:	Caregiver, Malou Simpson		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff do not have required training

INVESTIGATION FINDINGS:

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On 08/25/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to commence a complaint investigation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Administrator is not present in the facility. Facility staff contacted Administrator, Marilyn Gonzales, via telephone. LPA spoke with Administrator and received verbal permission to meet with Caregiver, Malou Simpson.

LPA reviewed records and interviewed staff during today's inspection. LPA observed required training to be documented in the personnel files. LPA confirmed with facility staff that staff have the required annual training. This agency has investigated the complaint alleging: Staff do not have required training. We have found that the complaint was UNFOUNDED, meaning the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted with Caregiver. A copy of this report was discussed and provided to Caregiver, Malou Simpson, whose signature on this form confirms receipt of this document.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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