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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247209077
Report Date: 12/06/2024
Date Signed: 12/07/2024 01:08:40 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
09/12/2024 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240912085948
FACILITY NAME:G.L.O.M A.R.F 7FACILITY NUMBER:
247209077
ADMINISTRATOR:KYLE KNOWLTONFACILITY TYPE:
735
ADDRESS:189 KORBEL AVENUETELEPHONE:
(925) 570-3282
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY:6CENSUS: 6DATE:
12/06/2024
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Laurein Pena, resident couclereTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Facility is in financial distress
Staff do not allow residents to go to religious services
Staff did not trasport residents in a safe manor
Staff do not meet the needs of residents in care
INVESTIGATION FINDINGS:
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On 12/06/2024, Licensing Program Analyst (LPA) V. Gorban visited the facility to deliver findings. During this visit LPA met with facility residential councelor Laureinv Pena and stated the purpose of the visit. During this visit LPA toured the facility inside and out, performing safety checks and observed clients in care.

Allegation: Facility is in financial distress. During complaint investigation department reviewed facility files, interviewed staff and administrator. During facility visit LPA observed facility food storage and observed facility in operations, no concerns reported from persons interviewed.

Allegation: Staff do not allow residents to go to religious services. During this visit LPA interviewed facility staff and clients. Based on staff interviews the faility provides rides to clients on vehicle that is functional. During clients in terviews no concerns reported. During files review no incident reported in regard to not allowing clientsto attend religious services.
Report continues on attached LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
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-20240912085948
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: G.L.O.M A.R.F 7
FACILITY NUMBER: 247209077
VISIT DATE: 12/06/2024
NARRATIVE
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Allegation: Staff did not transport residents in a safe manor. During this visit LPA interviewed facility clients, staff, and administrator. The facility vehicles transport clients to programs, events, and outings. Based on file review each facility has operating vehicle that accommodate 9 passengers. During file review no residents require special harness or equipment during transport.

Allegation: Staff do not meet the needs of residents in care. During this investigation department reviewed clients’ files. Based on interview and records review all clients are independent and do not require assistance with any needs. During interview client were able to respond to questions and aware how and to whom address to with concerns.

Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated .

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
LIC9099 (FAS) - (06/04)
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