157206891-12-8-2022-24-AS-SMOA-CM4PNK-20221214102803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157206891
Report Date: 12/08/2022
Date Signed: 12/08/2022 02:00:49 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
11/29/2022 and conducted by Evaluator Mai Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20221129124451

FACILITY NAME:	VILLAGE AT SEVEN OAKS ASSISTED LIVING, THE		FACILITY NUMBER:	157206891
ADMINISTRATOR:	JENKINS, KRYSTAL		FACILITY TYPE:	740
ADDRESS:	4301 BUENA VISTA RD		TELEPHONE:	(661) 837-1337
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93311
CAPACITY:	128	CENSUS: 72	DATE:	12/08/2022
		UNANNOUNCED	TIME BEGAN:	11:31 AM
MET WITH:	Krystal Jenkins, Executive Director Specialist and Pamela Bradley, Executive Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff did not give resident medications as prescribed.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 12/08/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial 10-day complaint inspection. LPA met with Krystal Jenkins, Executive Director Specialist discussed the purpose of the visit.

During the course of the investigation, the Department conducted interviews and records were reviewed. R1 moved into the facility without a doctor’s order for medication. The facility attempted multiples times to obtain medication list from the resident’s doctor.

Based on records reviewed and interviews which were conducted, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED. Exit interview conducted. A copy of this report was provided to the Executive Director Specialist.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Mai Yang	TELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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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