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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209320
Report Date: 05/14/2024
Date Signed: 05/15/2024 01:32:03 PM

Substantiated


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
05/02/2024 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20240502100522
FACILITY NAME:CENTER STREET BOARD AND CAREFACILITY NUMBER:
157209320
ADMINISTRATOR:BARBATO, ANTHONY M.FACILITY TYPE:
735
ADDRESS:2431 CENTER STTELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:22CENSUS: 22DATE:
05/14/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Regional Director Steven CruzTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Licensee is restricting access to clients P&I money
Facility staff are not properly addressing pest infestation in facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shawna Doucette conducted a visit to commence a complaint investigation. LPA identified herself and discussed the purpose of the visit and the elements of the allegations with Regional Director Steven Cruz.

LPA reviewed records and interviewed staff.

While at the facility, LPA asked to review P & I, however facility staff did not have access to the P & I or the P & I records. Clients were unable to access P& I yesterday or today.

Based on record review and interviews, facility is not following the recommendations of Pest control service.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
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 4
Control Number 24-AS-20240502100522
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: CENTER STREET BOARD AND CARE
FACILITY NUMBER: 157209320
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/15/2024
Section Cited
CCR
80070(b)(14)
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80026 Safeguards for Cash Resources, Personal Property, and Valuables of Residents (i) Immediately upon admission of a client, all of his/her cash resources entrusted to the licensee and not kept in the licensed facility shall be deposited in any type of bank, savings and loan, or credit union account meeting the following requirements:
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Plan of Correction POC Licensee agrees to come up with a plan to make funds accessible 24/7 to clients and will submit plan to licensing by POC due date 5/15/24
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(3) The licensee shall provide access to the cash resources upon demand by the client or his/her authorized representative.This requirement was not met as evidenced by: Licensee did not have P & I accessible to clients request for 5/13/24 and 5/14/24 which poses a potential health safety and or personal rights risk to residents in care.
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Type B
06/14/2024
Section Cited
CCR
80087(a)(1)
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80087 Buildings and Grounds
(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.(1) The licensee shall take measures to keep the facility free of flies and other insects.This requirement was not met as evidenced by LIcensee did not ensure the facility was free of pests (bed bugs) and did not follow Pest Control recommendation which poses a potential health safety and or personal rights risk to residents in care.
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Plan of Correction POC Licensee agrees to follow instructions of pest control company by tenting the facilty or doing an 8 hour heat treatment by POC due date 06/14/24. Licensee will submit proof of correction by a receipt from pest control company.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 24-AS-20240502100522
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: CENTER STREET BOARD AND CARE
FACILITY NUMBER: 157209320
VISIT DATE: 05/14/2024
NARRATIVE
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Based on record review and interviews, the preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

An exit interview was conducted with Regional Director Steven Cruz and a copy of this report along with appeal rights and plan of correction were provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
05/02/2024 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20240502100522

FACILITY NAME:CENTER STREET BOARD AND CAREFACILITY NUMBER:
157209320
ADMINISTRATOR:BARBATO, ANTHONY M.FACILITY TYPE:
735
ADDRESS:2431 CENTER STTELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:22CENSUS: 22DATE:
05/14/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Regional Director Steven CruzTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Facility staff speak inappropriately to clients
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shawna Doucette conducted a visit to commence a complaint investigation. LPA identified herself and discussed the purpose of the visit and the elements of the allegations with Regional Director Steven Cruz.

LPA interviewed clients and staff. It is unknown if staff spoke inappropriately to clients.

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.


An exit interview was conducted and a copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4