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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 05/16/2022
Date Signed: 05/16/2022 07:52:42 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
04/11/2022 and conducted by Evaluator Kelly J. McClurg
COMPLAINT CONTROL NUMBER: 24-AS-20220411164018
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: 76DATE:
05/16/2022
UNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Administrator (Admin) Ramona "Mona" Eleco;TIME COMPLETED:
08:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Inappropriate interactions occurred between residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A Complaint visit was conducted on the date & during the times indicated above by Licensing Program Analyst (LPA) K. McClurg. LPA met with Administrator (Admin) Ramona "Mona" Eleco.
The Department interviewed staff & residents (R1, R2, &3). The Department also reviewed resident's records & the submitted incident report. R3 confirmed that they intervened before anything inappropriate took place between R1 & R2. R1 denied the allegation. An incident report was submitted to the Department & facility has implemented increased supervision on R2 as a result of the incident. There is not a preponderance of evident to prove alleged violation occurred, therefore the allegation is Unsubstantiated.
Exit interview conducted with Admin. Report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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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