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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 155801189
Report Date: 10/28/2022
Date Signed: 10/28/2022 03:48:14 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
10/12/2022 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20221012162221
FACILITY NAME:WESTCHESTER GARDENSFACILITY NUMBER:
155801189
ADMINISTRATOR:ROBINSON, SHERVETAFACILITY TYPE:
740
ADDRESS:2228 TRUXTUN AVETELEPHONE:
(661) 324-3091
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY:36CENSUS: 16DATE:
10/28/2022
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Administrator, Sherveta RobinsonTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not properly relocate resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/28/22 Licensing Program Analyst (LPA) M. Garza arrived at facility to complete an unannounced visit. LPA met with Administrator, Sherveta Robinson and was not COVID pre-screened upon entry into the facility. LPA informed Administrator they were there to deliver findings on the above listed allegation. LPA completed a health and safety check on residents in care.

During investigation LPA completed interviews, reviewed documentation (physicians report, medical records, admissions agreement). Upon reviewing medical records it was found R1 is independent and does not have a POA. R1 was placed at the facility by Bakersfield Family Medical Center (BFMC) Case Manager for respite care. Upon discharge of treatment, Case Manager transferred R1 to New Pathways Board and Care. The facility did not have say in where R1 was to be placed.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is found to be UNSUBSTANTIATED.

Exit interview completed with Administrator, Sherveta Robinson. A copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -580-4596
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: 559-365-9009
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022
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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