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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247206921
Report Date: 04/29/2026
Date Signed: 04/29/2026 06:13:31 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
03/12/2026 and conducted by Evaluator Vadim Gorban
COMPLAINT CONTROL NUMBER: 24-AS-20260312083540
FACILITY NAME:MERCED SENIOR LIVINGFACILITY NUMBER:
247206921
ADMINISTRATOR:LISA BARICEVICFACILITY TYPE:
740
ADDRESS:3420 R STTELEPHONE:
(209) 580-6124
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY:93CENSUS: 86DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Lisa Baricevic, administratorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Staff did not ensure a plan for residents to be transported downstairs
INVESTIGATION FINDINGS:
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On 04/29/2026, Licensing Program Analyst (LPA) V Gorban conducted complaint investigation visit, introduced self and was allowed entry. LPA met with administrator Lisa Baricevic. The purpose of this visit is to deliver the findings of the investigation completed by the Department.
During the visit, LPA conducted a tour of the facility, interior and exterior to ensure there is no potential or immediate health and safety risk at the facility.
Allegation: Staff did not ensure a plan for residents to be transported downstairs. Based on interviews and records review, the facility prepared, and hold in place a disaster plan. Residents were notified via a in house note, contact personnel, and alternative way to transport residents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Report continues on attached LIC9099-A
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
03/12/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260312083540

FACILITY NAME:MERCED SENIOR LIVINGFACILITY NUMBER:
247206921
ADMINISTRATOR:LISA BARICEVICFACILITY TYPE:
740
ADDRESS:3420 R STTELEPHONE:
(209) 580-6124
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY:93CENSUS: 86DATE:
04/29/2026
UNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Lisa Baricevic, administratorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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9
Staff did not ensure elevator was fixed timely
INVESTIGATION FINDINGS:
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13
On 04/29/2026, Licensing Program Analyst (LPA) V Gorban conducted complaint investigation visit, introduced self and was allowed entry. LPA met with administrator Lisa Baricevic. The purpose of this visit is to deliver the findings of the investigation completed by the Department.
During the visit, LPA conducted a tour of the facility, interior and exterior to ensure there is no potential or immediate health and safety risk at the facility.

Allegation: Staff did not ensure elevator was fixed timely. Based on observation and interview, facility elevator is under repair and have not been operational for extended period of time which poses potential health and safety risk to persons in care. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations being cited on the attached LIC 9099D
Exit interview conducted, report signed and with appeal rights provided to administrator for facility records.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20260312083540
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: MERCED SENIOR LIVING
FACILITY NUMBER: 247206921
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/06/2026
Section Cited
CCR
87303(a)
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Maintenance and Operation. (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not observed as evidenced by:
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Licensee will follow up and provide updated information regarding elevator repair following plan of correction. With updates, regarding repair to be provided to LPA via email by POC due date.
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Based on observation, second elevator, (west side of the building) is not operational for prolonged time frame which poses potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3