157208773-2-2-2022-24-AS-MHON-CBXM23-20220224081249

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 02/02/2022
Date Signed: 02/02/2022 11:11:13 AM

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
12/02/2021 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20211202110000

FACILITY NAME:	JASMIN TERRACE AT BAKERSFIELD		FACILITY NUMBER:	157208773
ADMINISTRATOR:	ELECO, RAMONA D.		FACILITY TYPE:	740
ADDRESS:	5400 STINE ROAD		TELEPHONE:	(661) 398-8802
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93313
CAPACITY:	99	CENSUS: 74	DATE:	02/02/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Ramona Eleco, Administrator		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Facility accepted resident who needed higher level of care as the result of not conducting proper pre-assessment.
Facility rooms do not provide for easy passage for residents who use wheelchairs.
Resident had several unwitnessed falls as the result of insufficient staffing.

INVESTIGATION FINDINGS:

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On 02/02/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver complaint findings on the above allegations. LPA met with Administrator Ramona Eleco and stated purpose of visit.

During the course of the investigation, the Department conducted interviews, toured the facility and reviewed records. LPA reviewed resident’s and facility record which show proper pre-assessment was conducted prior to accepting the resident to the facility. Resident’s physician report, California Assisted Living Waiver program (ALW), and assessment were reviewed and confirmed resident did not need higher level of care. LPA toured facility and observed doorways to have proper passage. Records were review and staff interviews confirm adequate staffing.

Based on records reviewed, observations, and interviews which were conducted, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED. Exit interview conducted. As a COVID-19 precautionary measure, a copy of this report will be provided via email. Report signed on-site.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai Yang	TELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

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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