157203336-9-11-2020-24-AS-SPIY-BTGLFQ-20200915084331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157203336
Report Date: 09/10/2020
Date Signed: 09/11/2020 03:08:48 PM

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
08/18/2020 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200818160622

FACILITY NAME:	GOLDEN CASTLE ASSISTED LIVING		FACILITY NUMBER:	157203336
ADMINISTRATOR:	BRIZUELA, PAULA MARIBEL		FACILITY TYPE:	740
ADDRESS:	2607 MOUNT VERNON AVENUE		TELEPHONE:	(661) 871-8133
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93306
CAPACITY:	49	CENSUS:	DATE:	09/10/2020
		UNANNOUNCED	TIME BEGAN:	03:59 PM
MET WITH:	Maribel Brizuela		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Resident (R1) sustained an injury while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Les Xiong conducted the complaint investigation via televisit due to COVID-19 and pre-cautionary measures. LPA identified himself and discussed the purpose of the call and the elements of the allegation with Administrator Maribel Brizuela.

During the course of this investigation LPA reviewed facility files relevant to the complaint investigation. It was determined that the above allegation: Resident sustained an injury while in care is UNFOUNDED. Resident R1 has a history of having rashes and resident denies being abused by staff. This agency has investigated the complaint alleging (Resident sustained an injury while in care). We have found that the complaint was unfounded, therefore we have dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Les Xiong	TELEPHONE: (559) 410-1772
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2020

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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