107209048-5-18-2021-24-AS-MHON-C36U8V-20210519152206

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107209048
Report Date: 05/18/2021
Date Signed: 05/18/2021 01:58:06 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
11/20/2020 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20201120115518

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: 35	DATE:	05/18/2021
		UNANNOUNCED	TIME BEGAN:	01:09 PM
MET WITH:	Donna Hurley		TIME COMPLETED:	01:59 PM

ALLEGATION(S):

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Resident sustained a fracture while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct a subsequent visit to this complaint investigation. LPA met with Administrator, Donna Hurley

On 11/16/20, R1 was transferred via ambulance to Kaiser Permanente-Fresno for medical treatment due to COVID-19. R1 Further evaluation and x-rays showed a “mildly” displaced left femoral neck fracture, there was no bruising noted and no surgical intervention required. Facility has no records of R1 sustaining a fall. Prior x-rays in 2/2020 did not note any fractures. This Department has reviewed all records and is unable to determine when the fracture occurred.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegations is Unsubstantiated.

Exit interview conducted. No deficiency cited.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Melinda Medina	TELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021

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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