157202769-4-12-2025-24-AS-SPIY-DGFKHA-20250507075449

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157202769
Report Date: 04/12/2025
Date Signed: 04/12/2025 12:05:25 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
02/26/2025 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20250226161353

FACILITY NAME:	CARRINGTON OF SHAFTER		FACILITY NUMBER:	157202769
ADMINISTRATOR:	ALICIA WEBB		FACILITY TYPE:	740
ADDRESS:	250 EAST TULARE AVENUE		TELEPHONE:	(661) 746-6521
CITY:	SHAFTER	STATE: CA	ZIP CODE:	93263
CAPACITY:	64	CENSUS: 45	DATE:	04/12/2025
		UNANNOUNCED	TIME BEGAN:	10:28 AM
MET WITH:	Amanda Jaime		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff physically abusing resident

INVESTIGATION FINDINGS:

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On 4/12/2025, Licensing Program Analyst (LPA) M. Medina conducted an unannounced subsequent complaint visit to conduct additional interviews and deliver findings to complaint. LPA arrived and contacted Administrator by telephone who arrived a short time later to conduct complaint visit with LPA.

This Department investigated the allegation of staff physically abusing resident. During the investigation, this department conducted facility tour, conducted interviews, and reviewed records. Based on review of Resident 1 (R1) records and interviews, it was documented that R1 received injury while being transferred from bed to wheelchair. Hospice records document that R1 has thin, frail skin, and is at high risk for skin tears.

This Department has found that the above allegations are UNFOUNDED, meaning they were false, could not have happened, and/or were without reasonable basis. We have therefore dismissed the complaint.

No deficiencies issued during this complaint visit . Exit interview conducted. A copy of this report was provided to Administrator for facility records

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2025

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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