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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157202387
Report Date: 12/10/2021
Date Signed: 12/10/2021 01:17:29 PM

Substantiated


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
09/13/2021 and conducted by Evaluator Lady Cabrera
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210913163719
FACILITY NAME:MOUNTAIN VIEW RANCH RES. CAREFACILITY NUMBER:
157202387
ADMINISTRATOR:NANKIL, PATRICK R.FACILITY TYPE:
735
ADDRESS:3046 HINSLEY STTELEPHONE:
(661) 319-3749
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:4CENSUS: 4DATE:
12/10/2021
UNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Rosalina and Tony Nankil, LicenseeTIME COMPLETED:
01:16 PM
ALLEGATION(S):
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Staff physically abused resident while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) L. Cabrera conducted the subsequent complaint investigation visit to the facility. LPA met with Licensee Rosalina and Tony Nankil. Administrator was unavailable.

The Department determined based on the interviews and records review that the above allegation is SUBSTANTIATED. Based on interviews conducted there was sufficient evidence to corroborate that Staff hit Client (C1) with a belt on 05/20/2020. C1 confirmed being hit by staff. The Staff’s report of the incident was inconsistent and denied the allegation. Based on the Department observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

See LIC9099-D for Deficiency

A copy of this report and Appeal Rights have been provided and an exit interview was conducted with Administrator.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
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-20210913163719
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: MOUNTAIN VIEW RANCH RES. CARE
FACILITY NUMBER: 157202387
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/13/2021
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include...(3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation...

This requirement was not met as evidenced by:
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Licensee shall review 80072 Personal Rights and submit a written letter indicating they have read and understand the regulations to CCLD by 12/13/2021. Licensee will provide training for all facility staff regarding 80072 Personal Rights and submit training roster by 12/17/2021.
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Based on records review and interviews, the Licensee did not ensure the client being free from corporal or unusual punishment, which poses an immediate Health, Safety and Personal Rights risks to persons in care.
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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: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2