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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157204037
Report Date: 05/11/2024
Date Signed: 05/11/2024 04:01:46 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
05/06/2024 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20240506003721
FACILITY NAME:AIMES SHELLEYFACILITY NUMBER:
157204037
ADMINISTRATOR:CORTEZ, JOSEFACILITY TYPE:
735
ADDRESS:2808 SHELLEY LANETELEPHONE:
(661) 589-9992
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:4CENSUS: 4DATE:
05/11/2024
UNANNOUNCEDTIME BEGAN:
10:59 AM
MET WITH:Administrator Jose CortezTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are bullying a client while in care
Staff made an inappropriate comment towards a client
Staff did not provide a client privacy
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA identified herself and explained the purpose of the visit and the elements of the allegations. LPA was granted entry by Staff Yesenia Gomez. Administrator Jose Cortez responded to the facility to assist with the visit.

LPA interviewed clients and staff. LPA obtained copies of C1's file and S1's file.

Based on interviews, it is undetermined if Staff are bullying a client while in care, Staff made an inappropriate comment towards a client and if Staff did not provide a client privacy.

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, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2024
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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