157208940-1-31-2024-24-AS-SMOA-D26PED-20240205101454

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208940
Report Date: 01/31/2024
Date Signed: 01/31/2024 09:51:47 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
01/17/2024 and conducted by Evaluator Mai Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20240117135418

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: 118	DATE:	01/31/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Paul Anderson, Director of Residential Services Shellie Whitlock, and Director Kristen McMillian		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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9

Facility did not provide resident records to residents authorized representative.

INVESTIGATION FINDINGS:

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On 01/31/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to deliver complaint findings on the above allegation. LPA introduced self, stated the purpose of the visit and met with Administrator Paul Anderson, Director of Residential Services Shellie Whitlock, and Director Kristen McMillian.

During the course of the investigation, the Department conducted interviews and reviewed records. R1’s records were requested on 01/15/24 and the facility contacted the reporting party (RP) on 1/17/24 regarding the requested records. R1’s records were confirmed received by the RP. Based on interviews conducted, 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 Administrator, whose signature confirms receipt of this 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: 01/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024

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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