157208940-5-29-2024-24-AS-SMOA-D65JSU-20240611071854

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157208940
Report Date: 05/29/2024
Date Signed: 05/29/2024 01:29:19 PM

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
05/22/2024 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20240522090454

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: 121	DATE:	05/29/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Paul Anderson, Director of Residential Services Shellie Whitlock, and Office Manager Kourtney Fangmeyer		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff did not provide resident with the correct refund

INVESTIGATION FINDINGS:

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On 05/29/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial complaint investigation. LPA introduce self, stated the purpose of the visit, and met with Administrator Paul Anderson, Director of Residential Services Shellie Whitlock, and Office Manager Kourtney Fangmeyer.

During the course of the investigation, interviews were conducted, and records were reviewed. R1 and R2 has a moved in date of 02/27/24 and had moved out on 03/23/24. On 03/06/24, R1 made a payment of $11,807.00 towards R1 and R2’s community fee and rent for the month of March. The facility issued and mailed refunded check to the resident for the remaining dates of March after the resident moved out including 80% of the community fee.

Based on records reviewed and interviews which were conducted, the preponderance of evidence standard has not been met; therefore, the above allegation is found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided to the Administrator.

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: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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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