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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209360
Report Date: 10/25/2025
Date Signed: 10/25/2025 02:15:20 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
08/05/2025 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250805112857
FACILITY NAME:NORTHWEST VILLAFACILITY NUMBER:
107209360
ADMINISTRATOR:ROYCHOUDHURY, MINAKSHIFACILITY TYPE:
740
ADDRESS:542 W. BROWNING AVENUETELEPHONE:
(559) 448-8964
CITY:FRESNOSTATE: CAZIP CODE:
93704
CAPACITY:6CENSUS: 6DATE:
10/25/2025
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Shailesh "Steve" PatelTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident was injured by staff
Resident financially exploited by staff
Staff do not respond to resident's call for assistance in a timely manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On /1025/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced subsequent complaint visit to conduct additional interviews and deliver findings. LPA introduced self and stated purpose of visit, and allowed entrance by caregiver. LPA met with Administrator, Shailesh "Steve" Patel to conduct complaint visit.

During the subsequent visit, LPA conducted interview and delivered findings. During the course of the investigation, facility was toured, records reviewed, and interviews conducted. This department had insufficient information regarding the allegations listed above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or disprove that the allegation occurred therefore the allegation is UNSUBSTANTIATED.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2025
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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