155801264-10-18-2021-24-AS-MHON-C8LR5N-20211109114326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 155801264
Report Date: 10/18/2021
Date Signed: 10/18/2021 04:36:09 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
04/28/2021 and conducted by Evaluator Malia Thao

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20210428082757

FACILITY NAME:	HALLMARK OF BAKERSFIELD		FACILITY NUMBER:	155801264
ADMINISTRATOR:	MATTHEWS, SAVANNAH		FACILITY TYPE:	740
ADDRESS:	2001 AKERS ROAD		TELEPHONE:	(661) 834-0200
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93309
CAPACITY:	70	CENSUS: 52	DATE:	10/18/2021
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Ashley Candelas, Assistant Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Resident sustained an injury in care.
Licensee is not providing assistance in meeting resident's necessary medical needs.

INVESTIGATION FINDINGS:

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On 10/18/21 at 10:30 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to deliver findings. LPA was granted entry by front receptionist. LPA met with Assistant Administrator Ashley Candelas. Administrator Savannah Matthews was unavailable.

During the course of the investigation, LPA made observations, conducted interviews, and reviewed records. Based on LPA’s observations, interviews, and records reviewed, there was not sufficient evidence to show resident sustained injury while in care or that licensee did not provide assistance in meeting resident's necessary medical needs.The above allegations are unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted. A copy of this report will be emailed to the email address on record with "Read receipt" to confirm receipt of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Andy Xiong	TELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021

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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