157208773-8-15-2022-24-AS-SMOA-CHZMPY-20220906094755

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 08/15/2022
Date Signed: 08/15/2022 11:56:30 AM

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
08/11/2022 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20220811130931

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: 79	DATE:	08/15/2022
		UNANNOUNCED	TIME BEGAN:	11:51 AM
MET WITH:	Administrator Ramona Eleco		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff retaliated against resident for complaining
Staff withheld resident's medical supplies
Staff spoke inappropriately to resident
Staff handled resident in a rough manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) K. Kaur and Licensing Program Manager S. Moua conducted an initial complaint inspection to open the complaint. LPA and LPM met with Administrator Ramona. Findings were delivered.

The Department has interviewed staff and residents, toured the facility, and reviewed records. Residents’ medical supplies are from medical supply companies via insurance or families. Residents who request it will keep their supplies in their rooms. Residents with memory care will have their supplies kept, track, and inventoried by the facility. Medical supplies room was toured, and supplies were labelled for residents. Facility has a resident’s council that meets every month. Residents were interviewed regarding personal rights and care. There have been no specific incidents regarding staff handling residents roughly, speaking inappropriately to resident, or retaliation. The above allegations are Unsubstituted.

Exit Interview was conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: See Moua	TELEPHONE: (559) 580-4596
LICENSING EVALUATOR NAME: Kamaldeep Kaur	TELEPHONE: (559) 341-7449
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2022

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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