157208940-1-11-2024-24-AS-SMOA-CZDSDT-20240111124737

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208940
Report Date: 01/04/2024
Date Signed: 01/11/2024 11:47:44 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
11/28/2023 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20231128155556

FACILITY NAME:	MAGNOLIA PLACE		FACILITY NUMBER:	157208940
ADMINISTRATOR:	ANDERSON, PAUL		FACILITY TYPE:	740
ADDRESS:	8100 WESTWOLD DRIVE		TELEPHONE:	(661) 663-8400
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93311
CAPACITY:	146	CENSUS: 116	DATE:	01/04/2024
		UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Memory Care Director Kristen McMillian and Acting Director Resident Services Palvire Bassi		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff is financially abusing resident in care.

INVESTIGATION FINDINGS:

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On 01/04/24, Licensing Program Analyst (LPA) M.Yang arrived unannounced to deliver finding on the above allegation. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator Paul Anderson. LPA met with Memory Care Director Kristen McMillian and Acting Director of Resident Services (DRS) Palvire Bassi who stated Administrator is unavailable to attend meeting.

During the course of the investigation, the Department conducted interviews and reviewed records. Transportation is included in R1's monthly statement. For every transportation that requires the facility to provide a one on one escort for the resident for outing, the facility charges an additional $40 an hour. Resident received notice of facility additional charge when S1 was required to escort R1 at the bank when S1 transported R1 to the bank. The facility charged R1 an additional $40 when S1 escorted R1. Based on interviews conducted and records reviewed, the preponderance of evidence standard has not been met, therefore, the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to the DRS, whose signature confirms receipt of report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: See Moua	TELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai Yang	TELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

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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