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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157206770
Report Date: 11/08/2025
Date Signed: 11/08/2025 10:49:30 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
11/04/2025 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20251104132413
FACILITY NAME:POINTE AT SUMMIT HILLS, THEFACILITY NUMBER:
157206770
ADMINISTRATOR:PERLA PENAFACILITY TYPE:
740
ADDRESS:4501 UPLAND POINT DRIVETELEPHONE:
(661) 447-4800
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:170CENSUS: 83DATE:
11/08/2025
UNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Administrator Perla Pena and Welness Care Coordianator Liliana CaftilloTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff mishandled a resident's medication
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA)'s Shawna Doucette conducted a visit to commence a complaint investigation. LPA was granted entry by Staff. Staff contacted Administrator Perla Pena and Administrator responded to assist with the visit. LPA met with Administrator and Welness Care Coordianator Liliana Caftillo.

LPA interviewed staff. LPA reviewed records and obtained copies of R1's records.

Based on records review, R1 missed a medication for the month of October 2025 without a doctor order to discontinue or hold the medication. Based on interviews, staff did not contact R1's doctor regarding the missed medication. The preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, deficiencies are being cited on the attached 9099-D.

A copy of this report was provded along with appeal rights and plans of correction.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
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 2
Control Number 24-AS-20251104132413
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: POINTE AT SUMMIT HILLS, THE
FACILITY NUMBER: 157206770
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/09/2025
Section Cited
CCR
87465(a)(4)
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87465 Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:
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Licensee agrees to schedule a medication training and submit proof of scheduled by POC due date 11/09/25. Once training has been completed Licensee will submit training and staff trained.
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(4) The licensee shall assist residents with self-administered medications as needed. This requirement was not met as evicenced by Licensee did not administer one of R1's medications for the month of October 2025 and did not contact doctor to discontinue or hold the medication which poses an immediate health safety and or personal rights risk to residents 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.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2025
LIC9099 (FAS) - (06/04)
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