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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209417
Report Date: 09/25/2025
Date Signed: 09/25/2025 07:12:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
09/12/2025 and conducted by Evaluator Jimmy Duarte
COMPLAINT CONTROL NUMBER: 24-AS-20250912104637
FACILITY NAME:REAL CARE LLCFACILITY NUMBER:
157209417
ADMINISTRATOR:PELAYA, JESSICAFACILITY TYPE:
740
ADDRESS:818 REAL RDTELEPHONE:
(661) 760-7610
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:300CENSUS: 26DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator Jessica PelayaTIME COMPLETED:
07:30 PM
ALLEGATION(S):
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9
Facility is in disrepair
Unfingerprinted individuals on premises
Reporting requirements
INVESTIGATION FINDINGS:
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On 09/25/2025, Licensing Program Analysts (LPAs) J. Duarte and L. Salazar arrived at the facility unannounced to continue the investigation and deliver findings on the above allegations. LPAs were greeted by current Administrator (AD) Jessica Pelaya. LPAs stated the purpose of the visit.

LPAs toured facility with AD, reviewed facility records, interviewed residents and staff, reviewed residents files, and observed two individuals not on the facility schedule as employees, had personal belongings in rooms 166 and 269 and staff reported that they reside there. A Civil Penalty in the ammount of $500 for Criminal Record Clearance is here by assessed.

LPA J. Duarte observed room 174 to be floaded and with an industrial fan operating to air out the room. LPAs also observed multiple resident rooms and hallways throughout the facility with dirty and/or stained carpet, toilets, and showers. In addition the kitchen tiles have dirt built up in the groute.

LPAs reviewed resident records and interviewed R1, who stated went to the hospital on two occassions. A review of facility files, shows no incident report was submitted for R1's hospital visit.

Based on the information received, the preponderance of evidence standard has been met; therefore, the above allegations are found to be substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 9099-D. A Civil Penalty in the ammount of $500 per individual totaling, $1,000 for Criminal Record Clearance is here by assessed on LIC421BG.

An exit interview was conducted with AD and a plan of correction was developed by 10/02/2025. A copy of this report and appeal rights were discussed and provided at the time of visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Jimmy Duarte
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
09/12/2025 and conducted by Evaluator Jimmy Duarte
COMPLAINT CONTROL NUMBER: 24-AS-20250912104637

FACILITY NAME:REAL CARE LLCFACILITY NUMBER:
157209417
ADMINISTRATOR:PELAYA, JESSICAFACILITY TYPE:
740
ADDRESS:818 REAL RDTELEPHONE:
(661) 760-7610
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:300CENSUS: 26DATE:
09/25/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Administrator Jessica PelayaTIME COMPLETED:
07:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Improper admission
Facility has pest problem
INVESTIGATION FINDINGS:
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2
3
4
5
6
7
8
9
10
11
12
13
On 09/25/2025, Licensing Program Analysts (LPAs) J. Duarte and L. Salazar arrived at the facility unannounced to continue the investigation and deliver findings on the above allegations. LPAs were greeted by current Administrator (AD) Jessica Pelaya. LPAs stated the purpose of the visit.

Based on observation and although the allegations may have happened, there is not a preponderance of evidence to prove that the alleged violations occurred, therefore, the allegations are unsubstantiated. An exit interview was conducted and a copy of this report was left with the administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Jimmy Duarte
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 24-AS-20250912104637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: REAL CARE LLC
FACILITY NUMBER: 157209417
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Appeal Denied
Type A
09/26/2025
Section Cited
CCR
87355(b)
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87355 Criminal Record Clearance
(b) Prior to the Department issuing a license, the applicant, administrator and any adults other than a client, residing in the facility shall have a criminal record clearance or exemption.

This requirement was not met as evidenced by LPAs observation of two individuals not on the facility schedule as employees, had personal belongings in rooms 166 and 269 and staff reported that they reside there. A Civil Penalty in the ammount of $500 per individual for Criminal Record Clearance is here by assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal righs of persons in care.
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Administrator is immediately removing I1 & I2 from the property. I1 & I2 will not reside at the facility until a Livescan is completed and fingerprints are cleared.
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Deficiency Dismissed
Type B
10/02/2025
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation
(a) The facility shall be clean, safe, sanitary and in good repair at all times...

This requirement was not met as evidenced by LPA observed room 174 to be floaded and with an industrial fan to air out the room. LPAs also observed multiple resident rooms and hallways throughout the facility with dirty and/or stained carpet, toilets, and showers. In addition the kitchen tiles have dirt built up in the groute.
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Administrator has completed a cleaning schedule and task binder to ensure facility remains clean.

POC cleared during this visit.
Deficiency Dismissed
Type B
10/02/2025
Section Cited
CCR
87211(a)(1)(D)
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87211 Reporting Requirements
(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:
(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...
(D)Any incident which threatens the welfare, safety or health of any resident...

This requirement was not met as evidenced by LPAs interview with R1, who stated went to the hospital on two occassions. A review of facility files, shows no incident was submitted for R1's hospital visit.
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In addition, administrator stated they will provide training with staff on reporting requirements by POC due date of 10/02/2025.
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: Serigy Pidgirny
LICENSING EVALUATOR NAME: Jimmy Duarte
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3