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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 207209150
Report Date: 12/03/2021
Date Signed: 12/03/2021 02:43:14 PM



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
10/21/2021 and conducted by Evaluator David Ayers
COMPLAINT CONTROL NUMBER: 24-AS-20211021151326
FACILITY NAME:GOLDEN YEARS RESIDENTIAL CARE HOME, THEFACILITY NUMBER:
207209150
ADMINISTRATOR:LUARES, BERNARDINOFACILITY TYPE:
740
ADDRESS:160 S 13TH STREETTELEPHONE:
(707) 235-2717
CITY:CHOWCHILLASTATE: CAZIP CODE:
93610
CAPACITY:41CENSUS: 39DATE:
12/03/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Elizabeth Luares-Prasad - LicenseeTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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9
Facility is dirty
Staff treat residents with disrespect
Residents are not getting showers timely
Residents laundry is not getting done timely
INVESTIGATION FINDINGS:
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9
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13
On this date, Licensing Program Analyst(LPA) D. Ayers arrived at the facility unannounced to deliver complaint findings. LPA met with Licensee Elizabeth Laures-Prasad and discussed the purpose of the inspection.

During the course of the investigation, the Department conducted interviews, reviewed records, and inspected the facility. During inspection, the facility was observed to be clean, free of clutter, and odor-free. Residents and staff stated that residents are treated respectfully. Staff stated that one resident had been refusing their showers and laundry service, and that the Licensee was working with the Authorized Representative of the resident to meet her needs. The above allegation is Unfounded. No deficiencies were cited during the inspection. Exit interview conducted. A copy of the report was provided to the licensee via email.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: David AyersTELEPHONE: (559) 650-7925
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021
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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