107209048-12-1-2020-24-AS-AXIG-BWZU6U-20210106141856

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107209048
Report Date: 12/01/2020
Date Signed: 12/01/2020 03:53:46 PM

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
11/23/2020 and conducted by Evaluator See Moua

COMPLAINT CONTROL NUMBER: 24-AS-20201123121833

FACILITY NAME:	COMPASS POINTE MEMORY CARE		FACILITY NUMBER:	107209048
ADMINISTRATOR:	HURLEY, DONNA		FACILITY TYPE:	740
ADDRESS:	5425 W. SPRUCE AVE.		TELEPHONE:	(559) 840-9347
CITY:	FRESNO	STATE: CA	ZIP CODE:	93722
CAPACITY:	36	CENSUS: 33	DATE:	12/01/2020
		UNANNOUNCED	TIME BEGAN:	01:01 PM
MET WITH:	Administrator Donna Hurley		TIME COMPLETED:	01:02 PM

ALLEGATION(S):

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9

Staff unlawfully evicted resident while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) S. Moua contacted the facility via telephone to commence a complaint investigation via telephone due to COVID-19 and pre-cautionary measures. LPA identified herself and discussed the purpose of the call and the allegation with Administrator Donna.

LPA interviewed Donna and requested copies of Resident's file. LPA confirmed that resident, R1, still resides at the facility. An eviction never took place. Allegation is unfounded because R1 was never evicted. An exit interview was conducted and a copy of this report was provided via email.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Andy Xiong	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: See Moua	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2020

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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