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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157206907
Report Date: 09/13/2025
Date Signed: 09/13/2025 10:09:32 PM

Substantiated


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
09/10/2025 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20250910145849
FACILITY NAME:UNION VILLAFACILITY NUMBER:
157206907
ADMINISTRATOR:MONTIANO, NANCYFACILITY TYPE:
735
ADDRESS:1102 S. UNION AVE.TELEPHONE:
(661) 323-0768
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:89CENSUS: 52DATE:
09/13/2025
UNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Medical Technician, Sony MorenoTIME COMPLETED:
11:48 AM
ALLEGATION(S):
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Facility did not prevent physical abuse of resident
INVESTIGATION FINDINGS:
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On 9/13/2025 Licensing Progarm Analysts (LPAs) M. Garza and L. Salazar arrived at facility for an unannounced initial complaint visit. LPA met with Medical Technician, Sony Moreno. Adminitrator, Nancy Montiano was contacted and gave permission to complete visit with Sony. Facility was not toured due to the population of unhoused and mental health residents.

During visit LPAs conducted interivews, requested and reviewed documentation (physicians reports, pre-placement appraisals, needs and services plans, hospital discharge records, emergency identification information). Inteviews with R1 disclosed they had an phycial altercation where R1 slapped R2. R1 stated it was due to R2 breaking the toilet and sink. The preponderance of evidence standard has been met per Title 22. The allegation above is SUBSTANTIATED. Deficiency cited per Title 22 on attached 9099D. If deficiency is not corrected it poses a direct impact on residents in care.

Exit interview completed with Medical Technician, Maria "Sony" Moreno. A copy of the report, deficiency and appeal rights have been provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2025
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-20250910145849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: UNION VILLA
FACILITY NUMBER: 157206907
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2025
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights (a)...client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Administrator to provide all staff training on regulation. In service sign in sheet and training material to be submitted to CCL by POC date as proof of correction.
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This requirement was not met as evidene by: R1 disclosing they slapped R2 during an altercation for breaking the sink and toilet. This poses a potential health safety and or personal right 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: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2