107209631-5-13-2026-24-AS-SMOA-DUJS9S-20260529134112

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107209631
Report Date: 05/13/2026
Date Signed: 05/13/2026 11:49:52 AM

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
05/05/2026 and conducted by Evaluator Jacques Leffall

COMPLAINT CONTROL NUMBER: 24-AS-20260505110026

FACILITY NAME:	CLEAR VIEW RETIREMENT GROUP-KELLY		FACILITY NUMBER:	107209631
ADMINISTRATOR:	ALZINA, CODY		FACILITY TYPE:	740
ADDRESS:	425 W KELLY AVENUE		TELEPHONE:	(559) 552-2446
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY:	6	CENSUS: 5	DATE:	05/13/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Administrator: ALZINA, CODY		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff were unprepared to provide resident assistance with Oxygen as ordered

Staff did not provide assistance to residents during a power outage according to the facilities planned emergency procedures

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 5/13/26 at 9:00 am Licensing Program Analyst (LPA) J. Leffall conducted an initial complaint visit to open and to deliver findings on above allegations. LPA met with Adminstrator (A1) Cody Alzina.

The Department conducted interviews with staff, residents and obtained facility records. LPA observed the necessary items in case of emergency and power outages.

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 Administrator which confirms signature of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Jacques Leffall
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 1