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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209373
Report Date: 06/25/2025
Date Signed: 06/25/2025 12:19:54 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
06/24/2025 and conducted by Evaluator Mai Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250624115141
FACILITY NAME:KERN VILLAGE ASSISTED LIVING FOR SENIORSFACILITY NUMBER:
157209373
ADMINISTRATOR:BELL, ASHLEYFACILITY TYPE:
740
ADDRESS:32 BURLANDO ROADTELEPHONE:
(760) 376-1367
CITY:KERNVILLESTATE: CAZIP CODE:
93238
CAPACITY:22CENSUS: 21DATE:
06/25/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ashley Bell, AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff cross contaminating resident’s food.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 06/25/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to complaint investigation and deliver findings on the above allegation. LPA introduce self, stated the purpose of the visit, and met with Administrator Ashley Bell.

The Department conducted interviews and toured the facility. Each residents’ food was placed in separate plates before serving. Residents with restricted diet or with food allergy are placed in separate plates. Food is prepared in sanitized area with specific cutting board for meat products and vegetables. Therefore, the preponderance of evidence standard has been met, the above allegations is found to be UNSUBSTANTIATED. Exit Interview conducted. A copy of this report was provided to Administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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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