157206719-12-14-2022-24-AS-MHON-CMR3D4-20230103170855

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157206719
Report Date: 12/14/2022
Date Signed: 12/14/2022 10:38:02 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
08/17/2022 and conducted by Evaluator Malia Thao

COMPLAINT CONTROL NUMBER: 24-AS-20220817155043

FACILITY NAME:	PARK RCFE, THE		FACILITY NUMBER:	157206719
ADMINISTRATOR:	MALONE, CATHY		FACILITY TYPE:	740
ADDRESS:	311 GARNSEY AVENUE		TELEPHONE:	(661) 283-4160
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93309
CAPACITY:	9	CENSUS: 5	DATE:	12/14/2022
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Cathy Malone, Licensee/Administrator		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Neglect/lack of care and/or supervision resulting in pressure injury.
Insufficient staffing.

INVESTIGATION FINDINGS:

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On 12/14/22 at 8:40 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to deliver findings. LPA explained reason for inspection and was granted entry by staff. Licensee (LIC) Cathy Malone arrived a short time later.

During the course of the investigation, LPA reviewed records and conducted interviews. Based on records review and interviews, LPA found that there was not sufficient evidence to show neglect/lack of care and/or supervision resulting in pressure injury or that the facility had insufficient staffing. The above allegations are unsubstantiated. The allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted. Due to technical difficulties, a copy of this report was emailed to Licensee's email on file. LIC confirmed email has not changed.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) -341-3274
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: 559-470-9001
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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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