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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209136
Report Date: 03/17/2022
Date Signed: 03/17/2022 05:16:32 PM

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
09/17/2021 and conducted by Evaluator Malia Thao
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210917124853
FACILITY NAME:REDWOOD SENIOR LIVING BAKERSFIELDFACILITY NUMBER:
157209136
ADMINISTRATOR:ESPINAL, KENNYFACILITY TYPE:
740
ADDRESS:810 S UNION AVETELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:41CENSUS: 39DATE:
03/17/2022
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Anthony Barbato, LicenseeTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
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8
9
Facility staff did not notify resident's POA of change of condition.
Facility is not providing an opportunity for physical activity for resident in care.
Facility has insects.
INVESTIGATION FINDINGS:
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5
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9
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11
12
13
On 3/17/22 at 9:35 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint investigation and deliver findings. LPA entered the facility and met with staff. Licensee arrived a short time later.

During the course of the investigation, LPA made observations, and conducted interviews and records review. Based on the observations, interviews, and records review, LPA found that R1 did not have a change in condition after POA was obtained; R1 admitted denial of physical activity when offered and staff advised R1 would frequently asked to be taken back to bed when R1 was up and about in wheelchair or preferred to be left in bedroom; and although LPA observed flies present in the facility and facility did not obtain pest control to address issue of flies present in the facility, Licensee advised steps were taken to mitigate the flies by ensuring door latches were operating appropriately and window screens were intact, using fly strips in facility, taking trash out more frequently, and adjusting water sprinklers in front yard so there would be a smaller water source for flies. Continue on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 24-AS-20210917124853
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: REDWOOD SENIOR LIVING BAKERSFIELD
FACILITY NUMBER: 157209136
VISIT DATE: 03/17/2022
NARRATIVE
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Continued from LIC9099.

Therefore, the above allegations are unsubstantiated.

Exit interview conducted. Due to COVID-19 precautions, a copy of this report was emailed to email on record with Read receipt to confirm receipt of this report. LPA confirmed email on record is current, with Licensee.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Malia ThaoTELEPHONE: (559) 650-7931
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2