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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 02/02/2022
Date Signed: 02/02/2022 11:06:35 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
12/03/2021 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20211203100104
FACILITY NAME:JASMIN TERRACE AT BAKERSFIELDFACILITY NUMBER:
157208773
ADMINISTRATOR:ELECO, RAMONA D.FACILITY TYPE:
740
ADDRESS:5400 STINE ROADTELEPHONE:
(661) 398-8802
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:99CENSUS: 74DATE:
02/02/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ramona Eleco, AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff are retaliating against resident for making a complaint by forcing resident to move rooms
Resident's ceiling is in disrepair
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 and toured the facility. LPA interviewed resident and staffs. Based on the interviews conducted, the resident and staff confirmed resident was not forced to move rooms.

The Department conducted interviews and toured the facility. LPA checked and toured the ceiling in the resident’s room. Resident’s ceiling observed to not be in disrepair. The resident and staff verified that the ceiling is not disrepair.

Based on interviews and observation, the allegations above is UNFOUNDED, meaning it was false, could not have happened, and/or is without reasonable basis. We have therefore dismissed the complaint.
Exit interview conducted. As a COVID-19 precautionary measure, a copy of this report will be provided via email. Report signed on-site.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 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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