155801189-10-8-2021-24-AS-SPIY-C7TUSA-20211015155002

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 155801189
Report Date: 07/19/2021
Date Signed: 10/08/2021 12:05:03 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
03/12/2021 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20210312110021

FACILITY NAME:	WESTCHESTER GARDENS		FACILITY NUMBER:	155801189
ADMINISTRATOR:	ROBINSON, SHERVETA		FACILITY TYPE:	740
ADDRESS:	2228 TRUXTUN AVE		TELEPHONE:	(661) 324-3091
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93301
CAPACITY:	36	CENSUS: 14	DATE:	07/19/2021
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Administrator, Sherveta Robinson		TIME COMPLETED:	12:21 PM

ALLEGATION(S):

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Staff caused injuries to a resident while in care

INVESTIGATION FINDINGS:

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On 7/19/2021 Licensing Program Analyst arrived at facility to deliver findings on complaint listed above. LPA met with Administrator Sherveta and explained reason for visit. LPA toured facility to complete a Health and Safety check on residents in care. LPA observed residents in dining area, in rooms and outside on patio.

The Department conducted interviews and reviewed records. Facility staff denied causing R1’s injuries and stated R1’s lacerations were because of an unwitnessed fall. Facility staff stated medical attention was sought immediately after the facility was notified of the fall. Residents interviewed denied witnessing or experiencing any physical abuse. Based on interviews conducted, there is not a preponderance of evidence to prove the alleged violation did occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview completed, appeal rights given and a copy of this report was sent via email due to COVID precautionary measures being taken. A delivered and read receipt serve as confirmation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Mary Garza	TELEPHONE: (559) 365-9009
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2021

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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