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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157204205
Report Date: 11/10/2021
Date Signed: 11/10/2021 03:02:33 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
06/07/2021 and conducted by Evaluator Malia Thao
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210607115509
FACILITY NAME:EDGEMONT HOMEFACILITY NUMBER:
157204205
ADMINISTRATOR:ANGELES, REALIZAFACILITY TYPE:
735
ADDRESS:5501 EDGEMONT DRIVETELEPHONE:
(661) 833-8805
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:4CENSUS: 3DATE:
11/10/2021
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Cheryl McCraw, AdministratorTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff pours water on a client while in care.
Client is being mistreated while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/10/21 at 8:35 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint investigation. LPA explained reason for inspection and was granted entry by staff. Administrator (ADM) Cheryl McCraw arrived a short time later.

During the course of the investigation, LPA conducted interviews, reviewed records, and made observations. Based on LPA’s observations, interviews, and records reviewed, there was not sufficient evidence to show staff poured water on client or client is being mistreated while in care. The above allegations are unsubstantiated. The allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

An exit interview was conducted. A copy of this report will be emailed to the email address on record with "Read receipt" to confirm receipt of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Andy Xiong
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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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