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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247200745
Report Date: 12/22/2021
Date Signed: 12/28/2021 09:16:29 AM



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
11/12/2021 and conducted by Evaluator David Ayers
COMPLAINT CONTROL NUMBER: 24-AS-20211112090031
FACILITY NAME:NEW BETHANYFACILITY NUMBER:
247200745
ADMINISTRATOR:FONSECA, JULIAFACILITY TYPE:
740
ADDRESS:1441 BERKELEY DRIVETELEPHONE:
(209) 827-8933
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:76CENSUS: 44DATE:
12/22/2021
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Lucinda Fonseca - DirectorTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Residents call buttons are not answered timely due to insufficient staffing
Residents are not receiving showers timely due to insufficient staffing
Residents are not able to eat in the dining-room due to insufficient staffing
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) D. Ayers arrived at the facility unannounced to deliver complaint findings. LPA identified himself and discussed the purpose of the visit with Director Lucinda Fonseca.

During the course of the investigation, the Department conducted interviews, reviewed records, and toured the facility. Facility Director stated that multiple care staff have recently quit. The facility has been actively seeking additional staff, and provided a flier advertising avaiable positions. The Director has hired multiple new care staff. LPA observed a sample of residents' call buttons which were responded to in a timely manner upon activstion. Facility Director stated that call buttons are responded to within four minutes. Multiple staff carry pagers which alert them to calls for assitance. Residents have been receiving their showers timely. Some residents decline their showers when certain staff are unavailable to assist them. Many residents prefer to eat meals in their rooms, and meals are provided to them. Residents who prefer to eat in the dining room have the option to do so. The allegations are unsubstantiated. No Deficiencies cited. Exit interview conducted, and copy of this report was provided to the Director via email.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: David AyersTELEPHONE: (559) 650-7925
LICENSING EVALUATOR SIGNATURE:

DATE: 12/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2021
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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