157209146-7-9-2024-24-AS-SPIY-D8DJWN-20240822072500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157209146
Report Date: 07/09/2024
Date Signed: 07/09/2024 11:28:05 AM

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
05/08/2024 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20240508153114

FACILITY NAME:	QUALITY CARE ASSISTED LIVING		FACILITY NUMBER:	157209146
ADMINISTRATOR:	ESPINAL, ALMA		FACILITY TYPE:	740
ADDRESS:	2607 MT. VERNON AVENUE		TELEPHONE:	(661) 871-8133
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93306
CAPACITY:	54	CENSUS: 46	DATE:	07/09/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Administrator Nancy Cudal		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff does not ensure resident is provided clean clothing.
Staff does not ensure resident attends scheduled appointments.
Staff does not ensure resident is provided shoes.
Staff shaved resident's hair without resident's consent.
Staff does not allow resident to receive personal calls.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Shawna Doucette conducted an unannounced complaint visit and was granted entry by Administrator Nancy Cudal. LPA explained the purpose of the visit.

LPA interviewed staff. LPA obtained copies of residents file. LPA interviewed R1's family. LPA toured the facility and checked R1's room. LPA observed clean clothing for R1.

Based on observation and interviews LPA was unable to determine if there was a time R1 did not have clean clothing. During the course of the visit, LPA observed clean clothing in R1's closet and drawers.

Based on record review and interviews, LPA was unable to determine if staff ensures resident attends scheduled appointments. After records review, staff notes show R1 refused a medical appointment on May 7, 2024 which was rescheduled for May 31, 2024. After conducting interviews, it was found R1 does refuse medical appointments sometimes. During today's visit, R1 was at a medical appointment.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

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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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
05/08/2024 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20240508153114

FACILITY NAME:	QUALITY CARE ASSISTED LIVING		FACILITY NUMBER:	157209146
ADMINISTRATOR:	ESPINAL, ALMA		FACILITY TYPE:	740
ADDRESS:	2607 MT. VERNON AVENUE		TELEPHONE:	(661) 871-8133
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93306
CAPACITY:	54	CENSUS: 46	DATE:	07/09/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Administrator Nancy Cudal		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Resident developed a yeast infection while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Shawna Doucette conducted an unannounced complaint visit and was granted entry by Administrator Nancy Cudal. LPA explained the purpose of the visit.

Based on interviews and records review/MARS/Centrally Stored Log, After reviewing records, LPA did not see any medications for a yeast infection or any doctor diagnosis for a yeast infection for R1. After conducting interviews, staff was not aware of any diagnosis of a yeast infection for R1.

Based on LPA's interviews and records review, this agency has investigated the complaint alleging, Resident developed a yeast infection while in care. We have found that the complaint was UNFOUNDED, which means it could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint.

A copy of this report was provided.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

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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Control Number 24-AS-20240508153114

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: QUALITY CARE ASSISTED LIVING	FACILITY NUMBER: 157209146
	VISIT DATE: 07/09/2024

NARRATIVE

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Based on interviews, it is undetermined if R1 did not have shoes. After conducting interviews, it was found R1's shoes were misplaced and found in the laundry room.

Based on interviews with staff and R1's family, it is undetermined if staff shaved R1's hair without R1's consent.

Based on interviews, it is undetermined if staff do not allow resident to receive personal phone calls. After conducting interviews, it was found R1 sometimes denies phone calls.

Based on interviews, observations and records review, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A copy of this report was provided.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna Doucette	TELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024

LIC9099 (FAS) - (06/04)

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