<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209136
Report Date: 10/21/2021
Date Signed: 10/22/2021 08:54:14 AM



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
07/01/2021 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210701091250
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:
10/21/2021
UNANNOUNCEDTIME BEGAN:
10:52 AM
MET WITH:Licensee, Anthony BarbatoTIME COMPLETED:
01:29 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident was sexually assaulted while in care
Staff did not complete an individual written admission agreement with the resident or the resident's responsible person.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Darius Williamd conducted an unannounced Complaint visit to deliver findings. LPA Williams met with Licensee Anthony Barbato and discussed the purpose of the visit.

The Department has investigated the above allegations.

In regards to the allegation, resident was sexually assaulted while in care, based on the Department's conducted interviews and records reviews, the preponderance of evidence standard has been met, therefore the allegation has been SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Chapter 8, Article 8, Section 87468.1(a)(3) is being cited on the attached LIC 9099D.

*Continued on LIC 9099C*
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
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 7
Control Number 24-AS-20210701091250
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: 10/21/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
In regards to the allegation, staff did not complete an individual written admission agreement with the resident or the resident’s responsible party, LPA Williams reviewed R1’s records and the current admission agreement on file was from a prior facility, Rose Garden, License #157202405. There was not an Admission Agreement for Rosewood Senior Living Bakersfield on file.

Based on record review the preponderance of evidence standard has been met, therefore the allegation has been SUBSTANTIATED. Title 22 California Code of Regulation, Division 6, Chapter 8, Article 9, Section 87507(c) is being cited on the attached LIC 9099D.

LPA discussed plan of correction with Licensee.

An exit interview was conducted and a copy of this report and appeals rights was provided.

SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 7
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
07/01/2021 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210701091250

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:
10/21/2021
UNANNOUNCEDTIME BEGAN:
10:52 AM
MET WITH:Licensee, Anthony BarbatoTIME COMPLETED:
01:29 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident's responsible person was not notified of incident
Residents were left in soiled clothing
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Darius Williamd conducted an unannounced Complaint visit to deliver findings. LPA Williams met with Licensee Anthony Barbato and discussed the purpose of the visit.

LPA Williams conducted interviews, record reviews, and observations

In regards to the allegation, residen’s responsible party was not notified of incident, Witness 1 (W1) reported receiving notification of the incident on 6/21/2021; the same day of the occurrence of the incident. W1 reported not being notified of another incident that occurred April 2021, which at that time the facility was under a different Licensee and license. The current Licensee obtained their license on 5/18/2021.

*Continued on LIC 9099C*

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 24-AS-20210701091250
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: 10/21/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
In regards to the allegation, residents were left in soiled clothing, according to R1’s physicians report, R1 is able to care for their own toileting needs. According to Resident 2 and Resident 3, staff conduct approximately 30 minute checks and will assist with toileting as needed. LPA Williams did not observe any residents in soiled clothing.

Although the above allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 7
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
07/01/2021 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210701091250

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:
10/21/2021
UNANNOUNCEDTIME BEGAN:
10:52 AM
MET WITH:Licensee, Anthony Barbato TIME COMPLETED:
01:29 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility did not have telephone service
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Darius Williamd conducted an unannounced Complaint visit to deliver findings. LPA Williams met with Licensee Anthony Barbato and discussed the purpose of the visit.

Licensing Program Analyst conducted interviews and record reviews.

The Licensee reported phone service was out on June 20, 2021, due to unforeseen circumastances. The Licensee provided documentation reflecting, an appointment was scheduled with Spectrum to service the phone line on 6/22/2021. As of 10/21/2021, the facility has an active working phone line.

The Licensee took appropriate measures to fix the phone.

*Continued on LIC 9099C*
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 24-AS-20210701091250
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: 10/21/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
This agency has investigated the complaint alleging, facility did not have telephone service. We have found that the complaint was UNFOUNDED, meaning the allegation could not have happened or is without a reasonable basis, therefore we have dismissed the complaint.

An exit interview was conducted and a copy of this report was provided.
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC9099 (FAS) - (06/04)
Page: 7 of 7
Control Number 24-AS-20210701091250
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/22/2021
Section Cited
CCR
87468.1(a)(3)
1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in All Facilities; (a) Residents...shall have all of the following personal rights:; (3) To be free from punishment, humiliation, intimidation, abuse, or other actions...

This requirement was not met evident by:
1
2
3
4
5
6
7
POC was corrected on the spot. Resident 1 and the suspect no longer reside at the facility.

Additionally, The Licensee is conducting interviews on 10/21/2021, and 10/22/2021, to hire additional staff to increase supervision. Licensee has agreed to submit documentation
8
9
10
11
12
13
14
Based on interviews and record reviews, the Licensee did not ensure Resident 1 was free from being sexually assualted by another resident, which poses an immediate health and safety risk to person's in care.
8
9
10
11
12
13
14
to CCLD regarding the number of staffed hired and schedule on 10/25/2021.
Type B
10/29/2021
Section Cited
CCR
87507(c)
1
2
3
4
5
6
7
87507 Admission Agreements; (c) Admission agreements shall be signed and dated, ...by the resident or the resident’s representative,...no later than seven days following admission.

This requirement was not met evident by:
1
2
3
4
5
6
7
Resident 1 moved to another facility June 2021.

Licensee has agreed to audit files for current Admission Agreements, and the reasoning if an agreement is not current, by POC due date of 10/29/2021.
8
9
10
11
12
13
14
Based on interview and record reviews, the Licensee did not ensure an admission agreement was signed by Resident 1 or authorized representative, which poses a potential personal rights risk to persons in care.
8
9
10
11
12
13
14



Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 7