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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209035
Report Date: 03/26/2025
Date Signed: 03/26/2025 02:46:01 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
03/19/2025 and conducted by Evaluator Jacques Leffall
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250319083306
FACILITY NAME:TRUEWOOD BY MERRILL, CLOVISFACILITY NUMBER:
107209035
ADMINISTRATOR:MAZON, PAMELAFACILITY TYPE:
740
ADDRESS:675 W ALLUVIAL AVENUETELEPHONE:
(559) 325-8400
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY:148CENSUS: DATE:
03/26/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:General Manager: Michelle RamosTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure the facility is free of hazards

Staff are not following resident's care plan
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/26/25 at 12:00 pm Licensing Program Analyst (LPA) J. Leffall conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with General Manager (GM) Michelle Ramos and Health Services Director (HSD) Lori Johnson and stated purpose of visit.

The Department reviewed records and conducted an interview with facility GM. The Department toured the facility and checked the dining area. LPA observed dining tables over the outlets. GM and Kitchen staff stated residents move the table and expose the outlets. GM has ensured that kitchen staff keep the tables above the outlets to prevent exposure.

The Department reviewed records and conducted an interview with HSD. Upon interview and records reviewed, S1's frequency of showers increased, however her rate of pay did not increase.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is Unsubstantiated. No deficiencies were issued.

Exit interview conducted. A copy of this report was distributed to General Manager which confirms signature of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Jacques Leffall
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025
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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