157203336-3-12-2021-24-AS-SPIY-C2SU9Z-20210507152355

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157203336
Report Date: 09/29/2020
Date Signed: 03/12/2021 04:50:09 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
02/24/2020 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20200224091637

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:	09/29/2020
		UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Maribel Brizuela		TIME COMPLETED:	10:47 AM

ALLEGATION(S):

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Resident sustained pressure injuries while in care requiring hospitalization.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) L. Xiong called and spoke with Administrator Maribel Brizuela regarding the complaint allegation. Findings were delivered over the phone due to COVID 19 precautionary guidelines.
The Department has investigated the complaint alleging: Resident sustained pressure injuries while in care requiring hospitalization. Although R1 did sustained pressure injuries as alleged, interviews and records showed R1 was treated by the Wound Center and Around the Clock Home Care. R1’s dressings were changed daily as attested by S1 and S2. It’s unsure if the injuries were due to neglect or natural deterioration of R1’s health. Based on the interviews conducted and/or records review the above allegation is UNSUBSTANTIATED.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.

Unsubstantiated

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: 09/29/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020

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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