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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203993
Report Date: 07/15/2024
Date Signed: 08/01/2024 02:31:08 PM


Document Has Been Signed on 08/01/2024 02:31 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:ROSAMOND RESIDENTIAL HOME AT SCHERER DRIVEFACILITY NUMBER:
157203993
ADMINISTRATOR:HARDGE, A. TERRENCEFACILITY TYPE:
735
ADDRESS:3833 SCHERER DRIVETELEPHONE:
(661) 256-4413
CITY:ROSAMONDSTATE: CAZIP CODE:
93560
CAPACITY:6CENSUS: 4DATE:
07/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:33 AM
MET WITH:Administrator Terrence Hardge via telephoneTIME COMPLETED:
10:15 AM
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On 07/15/24, Licensing Program Analyst (LPA) Yang arrived unannounced and attempted to conduct case management visit to follow up with incident reports that facility had reported to the department. LPA knocked on the door and rang the doorbell with no answer. LPA contacted Administrator (A1) Terrence Hardge via telephone who stated is unable to attending inspection. LPA discussed with Administrator via telephone regarding incidents.

LPA discuss two incident report that was received by the department. One report the facility reported incident where Staff 1 (S1) yelled at Client 1 (C1). An internal investigation was completed where interviews were conducted with 2 verbal clients and multiple staff confirming S1 had yelled at C1.

The second report was received, the facility reported Staff 2 (S2) had asked multiple times for Client 2 (C2) into inappropriate behavior involving S2. Facility had completed an internal investigation where interviews were conducted with C1 and C2 confirming incident did occurred.

The third report was received, the facility reported S2 reported Staff 3 (S3) threaten client 3 (C3). Facility completed an internal investigation where interviews were conducted incident did not occurred.

The information provide will be reviewed; a follow up case management will be conducted if necessary. A copy of this report will be emailed to Administrator. Signed report on file.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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