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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247209026
Report Date: 02/03/2023
Date Signed: 02/07/2023 09:44:54 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
11/10/2022 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 24-AS-20221110160235
FACILITY NAME:LLC RETIREMENT HOMES IIFACILITY NUMBER:
247209026
ADMINISTRATOR:BRYANT, PAULAFACILITY TYPE:
740
ADDRESS:1944 FAXON DRTELEPHONE:
(209) 761-2478
CITY:ATWATERSTATE: CAZIP CODE:
95301
CAPACITY:6CENSUS: 5DATE:
02/03/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee, Lindsey LamersonTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
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9
Facility staff did not administer resident's medication as prescribed
Facility staff speak inappropriately to resident's
Facility staff restrict residents from filing complaints
INVESTIGATION FINDINGS:
1
2
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5
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to deliver findings on a complaint investigation. LPA met with Licensee, Lindsey Lamerson and explained the purpose of today's visit.

Regarding the allegation Facility staff did not administer resident's medication as prescribed. Based on facility records reviewed the facility staff did administer resident’s medication as prescribed. LPA Hurt reviewed Medication Administration Records for Resident 1 documenting all medications given as prescribed. Therefore, this allegation is UNSUBSTANTIATED. A finding that an allegation is unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Continued on 9099C...


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
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-20221110160235
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: LLC RETIREMENT HOMES II
FACILITY NUMBER: 247209026
VISIT DATE: 02/03/2023
NARRATIVE
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...Continued from 9099

Regarding the allegation Facility staff speak inappropriately to residents. Based on interviews conducted the facility staff is not speaking inappropriately to residents. LPA Hurt interviewed four facility staff who all stated they have never heard any staff speak inappropriately to residents inappropriately. Reporting party stated Staff 1 witnessed facility Staff 2 tell them “they would give them their medications when they wanted and not when he wanted.” LPA Hurt interviewed Staff 1 who stated they never heard any conversation between Reporting Party, and Staff 2 about medications. Therefore, this allegation is UNSUBSTANTIATED. A finding that an allegation is unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.


Regarding the allegation Facility staff restrict residents from filing complaints. Based on facility records reviewed this facility staff is not restricting residents from filing complaints. LPA Hurt reviewed facility "Admissions Agreement" Page 13 reads "Filing Complaints. Any person (not just residents or family members) or organization have the right to file a complaint with Community Care Licensing at 844-538-8766." LPA Hurt reviewed "Attachment to Admission Agreement #9: Grievances Procedures" documenting facility residents rights to file complaints. LPA Hurt observed residents have access to a phone at all times to use if they chose to file a complaint. Therefore, this allegation is UNSUBSTANTIATED. A finding that an allegation is unsubstantiated means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.



No Deficiencies cited today Per Title 22 Regulations.

Exit interview conducted with Licensee, Lindsey Lamerson and copy of report provided.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2