157208773-9-4-2024-24-AS-SPIY-D8ZRY4-20240911132544

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208773
Report Date: 09/04/2024
Date Signed: 09/04/2024 10:46:16 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
08/26/2024 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20240826133935

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:	09/04/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Activities Director Candaleria Carrillo and Administrator Ramona Eleco		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff do not ensure bed ridden residents are repositioned in a timely manner
Staff do not ensure residents receive feeding assistance
Staff do not prevent resident from having a physical altercations with other residents
Staff do not ensure residents personal property is safe guarded

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Shawna Doucette arrived at the facility unannounced to commence a complaint investigation. LPA identified herself and explained the purpose of the visit with Staff Darlene Ruano. LPA met with Activities Director Candaleria Carrillo and Administrator Ramona Eleco.

LPA interviewed staff and residents. LPA toured the facility.

Based on interviews, the facility does not currently have any bedridden residents residing in the facility, therefore respositioning is not necessary.
Based on interviews and reviewing records, R4 and R5 can feed themselves however facility staff have to follow up to ensure residents ate their food. Per R4 and R5's LIC 602 both residents are able to feed themselves.

Based on interviews, facility was not made aware a resident was hitting another resident until the Residents's

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024

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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Control Number 24-AS-20240826133935

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: JASMIN TERRACE AT BAKERSFIELD	FACILITY NUMBER: 157208773
	VISIT DATE: 09/04/2024

NARRATIVE

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Council meeting on 8/28/24. Facility has taken precautions and advised R1 to let staff know if R6 enters the room. R1 is able to lock the door at night, which has resolved the issue. Although this may have happened, facility staff took precautions once staff was made aware.

After conducting interviews, it was found facility provide residents with a wheelchair or walker if needed until the residents insurance approves the wheelchair or walker. Once the new walker or wheelchair arrive, residents get the wheelchair or walker that was provided by their insurance.

Based on records review and interviews, it is undetermined whether or not the allegation occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A copy of this report was provided to Administrator.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024

LIC9099 (FAS) - (06/04)

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