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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 207201518
Report Date: 11/17/2023
Date Signed: 11/17/2023 12:28:53 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
11/15/2023 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20231115140342
FACILITY NAME:SVS OAKHURST ADULT DAY PROGRAMFACILITY NUMBER:
207201518
ADMINISTRATOR:LAWRENCE, CHRISTINEFACILITY TYPE:
775
ADDRESS:49234 GOLDEN OAK DRIVETELEPHONE:
(559) 692-2922
CITY:OAKHURSTSTATE: CAZIP CODE:
93644
CAPACITY:75CENSUS: 32DATE:
11/17/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Christine LawrenceTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff did not prevent resident from being hit by another resident.
INVESTIGATION FINDINGS:
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On 11/17/23 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to conduct an investigation regarding the allegation(s) listed above. LPA introduced herself and explained the reason for the visit. LPA met with Administrator (AD) Christine Lawrence.

1. The Department investigated the allegation: Staff did not prevent resident from being hit by another resident. LPA interviewed staff who verified this is unusual behavior for the clients involved in the incident. Interviewed staff stated their training's have prepared them for incidents that may arise with behaviors, but this behavior was not avoidable since there was no indication of behavior escalating and it was an unusual behavior.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
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 2
Control Number 24-AS-20231115140342
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: SVS OAKHURST ADULT DAY PROGRAM
FACILITY NUMBER: 207201518
VISIT DATE: 11/17/2023
NARRATIVE
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Administrator stated the individuals were separated, meetings were held with the individuals and their responsible parties, the police department was contacted but only an event number was provided. Administrator stated there have been no other incidents of aggression.

LPA toured the inside of the facility to verify there was no immediate dangers.

LPA collected copies of IPPs for clients listed on the incident reports, staff schedule for the date of incident, verification of current CPI training, and procedures on reporting.

After conducting interviews and reviewing records the following finding was delivered for the allegation listed above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

At this time LPA did not find any deficiencies and no citations were issued.

Exit interview was conducted and a copy of this report LIC809 was provided to Administrator Christine.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2