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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157202789
Report Date: 11/20/2023
Date Signed: 11/20/2023 10:46:10 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
10/04/2023 and conducted by Evaluator Malia Thao
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20231004142539
FACILITY NAME:SVS BAKERSFIELD ADULT DAY PROGRAMFACILITY NUMBER:
157202789
ADMINISTRATOR:GREEN, VICTORIA A.FACILITY TYPE:
775
ADDRESS:3601 UNION AVETELEPHONE:
(661) 323-0533
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93305
CAPACITY:90CENSUS: 53DATE:
11/20/2023
UNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Victoria Green, AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff cursed at a client.
INVESTIGATION FINDINGS:
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On 11/20/23 at 9:32 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint inspection. LPA explained reason for inspection and met with Administrator Victoria Green.

LPA conducted interviews and obtained records. Based on interviews and record review, LPA found that S1 cursed at C1. C1 stated S1 cursed at C1 jokingly and at times was unsure if S1 was joking. S2 stated S2 witnessed S1 curse at C1. S1 denied using inappropriately language with clients in care. The above allegation is substantiated. A deficiency is being cited based on LPA interviews conducted and record review in accordance with the California Code of Regulations, Title 22, see LIC9099D.

Exit interview conducted and a Plan of Correction was reviewed and developed with the Administrator. A copy of this report and appeal rights were given to Administrator, whose signature confirms receipt of this report.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
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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Control Number 24-AS-20231004142539
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: SVS BAKERSFIELD ADULT DAY PROGRAM
FACILITY NUMBER: 157202789
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2023
Section Cited
CCR
82072(a)(3)
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82072 Personal Rights (a) Each client shall have personal rights which include…(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature…
This was not met as evidenced by:
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Administrator will submit proof of an in-service training for all staff on client personal rights, to CCL by POC due date.
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Based on interviews and record review, LPA found that S1 cursed at C1. C1 stated S1 cursed at C1 jokingly and at times was unsure if S1 was joking. S2 stated S2 witnessed S1 curse at C1. This poses a potential personal rights risk to clients 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: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023
LIC9099 (FAS) - (06/04)
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