160400627-8-1-2023-24-AS-MHON-CUCU6T-20230803151852

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 160400627
Report Date: 07/31/2023
Date Signed: 08/01/2023 06:16:46 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
06/22/2023 and conducted by Evaluator Lisa Salazar

COMPLAINT CONTROL NUMBER: 24-AS-20230622094343

FACILITY NAME:	VALLEY CHRISTIAN HOME		FACILITY NUMBER:	160400627
ADMINISTRATOR:	ALVIDREZ, ERIN		FACILITY TYPE:	740
ADDRESS:	511 E. MALONE ST.		TELEPHONE:	(559) 585-3000
CITY:	HANFORD	STATE: CA	ZIP CODE:	93230
CAPACITY:	131	CENSUS: 65	DATE:	07/31/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Erin Alvidrez, Administrator		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff do not ensure resident rooms are cleaned adequately.

INVESTIGATION FINDINGS:

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On 07/31/23, Licensing Program Analyst, (LPA) L. Salazar arrived at the facility unannounced to deliver findings on the above allegation. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility.

During the investigation, LPA reviewed records that include R1's admission agreement, needs and service plan, facility's cleaning schedule, and staff's cleaning duties. Page 2 (#13) of the signed Admission agreement dated 09/06/22, shows "cleaning of resident's room", as a basic service but is not itemized.

LPA observed a cleaning duty checklist for the Housekeepers. Checklist shows daily duties Monday- Friday, weekly duties and monthly duties. "Deep Vacuuming" of room, to include furniture and under the bed, are listed as a monthly duty.

(Continued on 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa Salazar	TELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

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
06/22/2023 and conducted by Evaluator Lisa Salazar

COMPLAINT CONTROL NUMBER: 24-AS-20230622094343

FACILITY NAME:	VALLEY CHRISTIAN HOME		FACILITY NUMBER:	160400627
ADMINISTRATOR:	ALVIDREZ, ERIN		FACILITY TYPE:	740
ADDRESS:	511 E. MALONE ST.		TELEPHONE:	(559) 585-3000
CITY:	HANFORD	STATE: CA	ZIP CODE:	93230
CAPACITY:	131	CENSUS: 65	DATE:	07/31/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Erin Alvidrez, Administrator		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff do not assist resident with bathing as needed
Licensee does not ensure facility exits are adequately monitored on weekends.

INVESTIGATION FINDINGS:

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On 07/31/23, Licensing Program Analyst, (LPA) L. Salazar arrived at the facility unannounced to deliver findings on the above allegations. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility.

LPA reviewed facility shower logs that include a anatomical resident observation form. Facility records show R1 received assistance on schedule shower days of Tuesday's and Friday's, with the exception of 06/20/23. On 06/20/23, logs show resident refused showering that day. LPA interviewed R1, who confirmed refusing showers on occasion.

LPA toured the facility and reviewed the plan of operation for the facility. Facility does not advertise as a Memory Care unit and does not have a locked perimeter. LPA reviewed personnel schedules and observed the number of personnel on duty to be adequate.

We have found that the complaint was unfounded, meaning that the allegations are false, could not have happened and/or are without reasonable basis, therefore, we have dismissed the complaint. Exit interview conducted. A copy of this report was provided to Administrator.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa Salazar	TELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

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-20230622094343

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: VALLEY CHRISTIAN HOME	FACILITY NUMBER: 160400627
	VISIT DATE: 07/31/2023

NARRATIVE

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(Continued from 9099)

It is noted on the checklist, that housekeeping services are always provided in cases where accidents or messes need immediate attention. Facility has 2.5 housekeepers Monday through Friday, and care providers perform daily duties on Saturday and Sunday.

LPA toured R1's room and observed the room to be clean and free from odor. R1 stated their bed was not purchased by the facility, but brought from home. LPA observed R1's bed to be larger than the average facility twin bed that is provided to residents. R1's bed has a fabric chest attached to the foot of the bed that does not allowed the bed to moved.

LPA toured the facility housekeeping storage room where the facility vacuum's are located. Vacuums were observed to have a detachable wand for hard to reach areas. LPA observed additional resident rooms to have twin beds provided by the facility. Interviews with Administrator state the facility was unaware of any concerns of uncleanliness, as this was never brought to the attention of staff and/or Administration.

Although the allegation may have happened, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated. Exit interview conducted and copy of report was provided to Administrator. No deficiencies cited.

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SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Lisa Salazar	TELEPHONE: (559) 691-0004
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

LIC9099 (FAS) - (06/04)

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