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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157206891
Report Date: 06/21/2022
Date Signed: 06/21/2022 11:42:56 AM

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
06/16/2022 and conducted by Evaluator Lisa Salazar
COMPLAINT CONTROL NUMBER: 24-AS-20220616110043
FACILITY NAME:VILLAGE AT SEVEN OAKS ASSISTED LIVING, THEFACILITY NUMBER:
157206891
ADMINISTRATOR:CANO, EDIEFACILITY TYPE:
740
ADDRESS:4301 BUENA VISTA RDTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:128CENSUS: DATE:
06/21/2022
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Julius Osorio, Operations Specialist TIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
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9
Staff disclosed a resident's personal information while in care
INVESTIGATION FINDINGS:
1
2
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9
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13
On 06/21/2022, Licensing Program Analyst (LPA) L. Salazar arrived at the facility unannounced to conduct the required 10-day site inspection. LPA was greeted by Operations Specialist, stated the purpose of the visit and was allowed entry into the facility. COVID precautionary measures were taken at the time of entry.

LPA conducted interviews and reviewed records. Interviews reveal that personal information disclosed in Resident R1's pre-appraisal assessment for alternative placement, was provided to the family from a formal employee of Village at the Seven Oaks, who had prior knowledge of R1's personal information.

Although the allegation may have happened, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated. Exit interview conducted and copy of report was left with Operations Specialist. No deficiency cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa SalazarTELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
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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