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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157206732
Report Date: 01/26/2024
Date Signed: 01/26/2024 12:28:45 PM

Substantiated


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
12/13/2023 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20231213144812
FACILITY NAME:PARADISE GARDENSFACILITY NUMBER:
157206732
ADMINISTRATOR:DIANA ELLISFACILITY TYPE:
740
ADDRESS:15318 LILA ROSE CT.TELEPHONE:
(661) 829-1531
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY:6CENSUS: 5DATE:
01/26/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator, Diana EllisTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff served residents expired food
INVESTIGATION FINDINGS:
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On 01/26/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Diana Ellis.

During the course of this investigation, LPA conducted a facility tour, reviewed records, and interviewed staff. On 10/23/2023, LPA conducted a facility tour. During the tour LPA observed some food items that were expired/past the “best by” date indicated on the packaging. LPA also observed fruits and vegetables that were discolored. Consistent statements from interviews conducted revealed that the facility accepted/received donated food items. The items that were received were expired or “very close to the best by date” upon receipt.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 24-AS-20231213144812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: PARADISE GARDENS
FACILITY NUMBER: 157206732
VISIT DATE: 01/26/2024
NARRATIVE
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Based on observation and interviews conducted, the preponderance of evidence standard has been met therefore the allegation: Staff served residents expired food is SUBSTANTIATED.

A deficiency is being cited in accordance to California Code of Regulations, Title 22, Division 6 on the attached 9099D.

Exit interview conducted and plans for corrections have been reviewed and developed. A copy of this report and appeal rights were discussed and provided to Administrator, Diana Ellis whose signature on this form confirms receipt of this document.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
12/13/2023 and conducted by Evaluator Alexandria Walton
COMPLAINT CONTROL NUMBER: 24-AS-20231213144812

FACILITY NAME:PARADISE GARDENSFACILITY NUMBER:
157206732
ADMINISTRATOR:DIANA ELLISFACILITY TYPE:
740
ADDRESS:15318 LILA ROSE CT.TELEPHONE:
(661) 829-1531
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY:6CENSUS: 5DATE:
01/26/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator, Diana EllisTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff did not treat resident with respect
Staff does not provide a comfortable room temperature for residents
Staff does not provide adequate amount of food for residents
INVESTIGATION FINDINGS:
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On 01/26/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Diana Ellis

During the course of this investigation, LPA conducted a facility tour, reviewed records, and interviewed staff. Interviews conducted revealed that facility staff have access to the thermostat in the facility and are able to adjust the temperature in the facility depending on resident needs. During the facility tour, LPA observed that the facility was at a comfortable temperature. Residents are given additional servings of food when requested. CONTINUED TO 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 24-AS-20231213144812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: PARADISE GARDENS
FACILITY NUMBER: 157206732
VISIT DATE: 01/26/2024
NARRATIVE
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Based on interviews and observation, the allegations: Staff did not treat resident with respect; Staff does not provide a comfortable room temperature for residents; and Staff does not provide adequate amount of food for residents, are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies were issued during this inspection.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Diana Ellis whose signature on this form confirms receipt of this document.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
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
12/13/2023 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20231213144812

FACILITY NAME:PARADISE GARDENSFACILITY NUMBER:
157206732
ADMINISTRATOR:DIANA ELLISFACILITY TYPE:
740
ADDRESS:15318 LILA ROSE CT.TELEPHONE:
(661) 829-1531
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY:6CENSUS: 5DATE:
01/26/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator, Diana EllisTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Staff left resident soiled in urine and feces resulting in a rash
INVESTIGATION FINDINGS:
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On 01/26/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Diana Ellis.

During the course of this investigation, LPA conducted a facility tour, reviewed records, and interviewed staff. Interviews revealed that R1 does not reside at the above facility. This agency has investigated the complaint alleging: Staff left resident soiled in urine and feces resulting in a rash. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Diana Ellis, whose signature on this form confirms receipt of this document.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 24-AS-20231213144812
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: PARADISE GARDENS
FACILITY NUMBER: 157206732
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/02/2024
Section Cited
CCR
87555(a)
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(a)The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared, and served in a safe and healthful manner... this requirement was not met as evidenced by
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Administrator removed non-perishable foods from the pantry that were past the best buy date and removed discolored fruits and vegetables. Facility has begun shopping more frequently. POC CLEARED.
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Based on observation and interviews, the facility did not comply with section 87555 when the facility accepted and used food donations that were past the best buy date, which is a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6