157208773-8-15-2022-24-AS-SMOA-CHZMP8-20220906094639

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 08/15/2022
Date Signed: 08/15/2022 11:45:47 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
08/08/2022 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20220808103534

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:	10:15 AM
MET WITH:	Administrator Ramona Eleco		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff are not stopping resident from displaying genitals to residents
Staff are not stopping resident from eliminating throughout the facility
Resident urinated on another resident
Staff do not stop residents from bullying another resident
Staff do not afford a resident (s) dignity and respect in their relationships

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) K. Kaur and Licensing Program Manager S. Moua conducted an initial complaint inspection and deliver findings. LPA and LPM met with Administrator Ramona and discussed the findings.

The Department has interviewed staff and residents, toured the facility, and reviewed records. Based on interviews conducted, observations, and records reviewed, the above allegations are Unsubstantiated. R1 referenced in the complaint was newly admitted into the facility with dementia. R1 has uncontrollable bladder. Facility implemented incontinence care plan for R1 and in-service training was completed. Residents interviewed stated that facility staff redirects R1. Residents referenced in the complaint regarding bullying were interviewed and denied the allegations.

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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