<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157200963
Report Date: 04/29/2025
Date Signed: 04/29/2025 11:28:59 AM

Substantiated


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
03/06/2025 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20250306124021
FACILITY NAME:KERN ADULT PROGRAM, INC.FACILITY NUMBER:
157200963
ADMINISTRATOR:NORIEGA, JOHNFACILITY TYPE:
775
ADDRESS:2900 EYE ST.TELEPHONE:
(661) 323-4700
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY:120CENSUS: 90DATE:
04/29/2025
UNANNOUNCEDTIME BEGAN:
09:08 AM
MET WITH:Administrator, John NoriegaTIME COMPLETED:
11:29 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff do not ensure that clients are accorded privacy when using the restroom.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/29/2025 Licensing Program Analyst (LPA) M. Garza arrived to complete a complaint visit. LPA met with Administrator, John Noriega, explained reason for visit and was permitted entry into the facility. LPA completed a tour of the facility and a health and safety check on clients in care.

During visit on 3/7/2025 facility was toured, copies of LIC 500 (Personnel Record), LIC 9020 (Register of Facility Clients/Residents), employee contact information and pictures were taken. During todays visit LPA completed a tour of the facility,gathered documentation (resident roster, staff schedule, configuation list, identification for staff, job descriptions and reviewed resident and staff files, took pictures and completed interviews. During visit (3/7/2025) it was observed restoom stall door in building A (men's) did not properly lock. The preponderance of evidence standard has been met per Titile 22 and the allegation listed above is SUBSTANTIATED. Deficiency cited per Title 22 on 9099D.

Exit interview completed with Administrator, John. A copy of this report, deficiency and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
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 2
Control Number 24-AS-20250306124021
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: KERN ADULT PROGRAM, INC.
FACILITY NUMBER: 157200963
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/09/2025
Section Cited
CCR
80088(e)(3)
1
2
3
4
5
6
7
80088 Furniture, Fixtures, Equipment, and Supplies
(e) Faucets used by clients for personal care such as shaving and grooming shall deliver hot water. (3) All toilets, hand washing and bathing facilities shall be maintained in safe and sanitary operating condition...
1
2
3
4
5
6
7
Administrator stated the lock was fixed and a guard was placed over the hole on both sides for privacy. Administrator stated they will eventually be getting the stalls replaced. Picture will be provided as proof of correct to CCL by POC date.
8
9
10
11
12
13
14
This requirement was not met as evidence by LPA observation, the licensee did not comply with the section cited above in that the facility bathroom door was broken (men’s) in building A. This poses a potential health safety and or personal rights risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2