157202769-6-30-2023-24-AS-MHON-CUJUBE-20230809152610

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157202769
Report Date: 06/30/2023
Date Signed: 06/30/2023 12:23:42 PM

Unsubstantiated

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
06/16/2023 and conducted by Evaluator Alexandria Walton

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20230616170920

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: 46	DATE:	06/30/2023
		UNANNOUNCED	TIME BEGAN:	11:52 AM
MET WITH:	Administrator Assistant, Britney Sanchez		TIME COMPLETED:	12:38 PM

ALLEGATION(S):

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Staff made an inappropriate comment towards resident

INVESTIGATION FINDINGS:

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On 06/30/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegation. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Administator, Alicia Webb was not available to met during today's visit. LPA met with Administrator Assistant, Britney Sanchez.

Based on interviews conducted, the allegation: Staff made an inappropriate comment towards resident is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Administrator Assistant, Britney Sanchez whose signature on this form confirms receipt of this document.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria Walton	TELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023

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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