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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247200745
Report Date: 04/18/2022
Date Signed: 04/19/2022 01:50:17 PM

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
02/08/2022 and conducted by Evaluator David Ayers
COMPLAINT CONTROL NUMBER: 24-AS-20220208163352
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: 45DATE:
04/18/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Lucinda Fonseca - Administrator TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility food is spoiled.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this date, Licensing Program Analyst (LPA) David 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, toured the facility, inspected facility kitchen and food supply, and requested records. During a tour of the facility, the food supply was observed to be fresh and properly stored. No spoiled food was observed. Although one spoiled cabbage had admittedly been discovered in the kitchen, no spoiled food was served to residents and the spoiled cabbage was immediately removed. The facility employs a full-time chef and a dietician. No deficiencies cited during the inspection. Exit interview conducted with Director and a copy of this report provided to the licensee via email. A read receipt confirms the Licensee receives these documents.
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: 04/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022
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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