247209172-11-18-2024-24-AS-BCHN-DCA5QS-20241224190957

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 247209172
Report Date: 11/18/2024
Date Signed: 11/18/2024 07:01:20 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
07/29/2024 and conducted by Evaluator Brianna Miranda

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20240729111516

FACILITY NAME:	VALLEY SPRING MEMORY CARE		FACILITY NUMBER:	247209172
ADMINISTRATOR:	REYNAGA, ELIZABETH		FACILITY TYPE:	740
ADDRESS:	555 MILLER LANE		TELEPHONE:	(209) 710-4783
CITY:	LOS BANOS	STATE: CA	ZIP CODE:	93635
CAPACITY:	50	CENSUS: 26	DATE:	11/18/2024
		UNANNOUNCED	TIME BEGAN:	05:18 PM
MET WITH:	Executive Director Krista Willson		TIME COMPLETED:	06:30 PM

ALLEGATION(S):

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Staff did not ensure resident received medical attention in a timely manner.
Staff does not ensure residents are spoken to in appropriate manner.
Staff does not ensure the facility is kept in clean sanitary conditions for residents in care
Staff does not ensure residents care needs are being met
Staff does not ensure medications are dispensed as prescribed
Staff does not ensure residents records are properly managed
Staff does not ensure medications are properly stored
Staff does not ensure food of good quality is served to residents
Staff does not ensure residents dietary plan is being followed

INVESTIGATION FINDINGS:

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On 11/18/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself and explained the reason for the visit and met with Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.

1. The Department investigated the allegation: Staff did not ensure resident received medical attention in a timely manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they have not witnessed residents not receiving medical attention in a timely manner. Interviewees stated staff are quick to assist resident in need and to be sent out to the hospital is needed.

2. The Department investigated the allegation: Staff does not ensure residents are spoken to in appropriate manner. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated they have not witnessed residents being spoken to inappropriately.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brianna Miranda	TELEPHONE: 559-770-0254
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024

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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Control Number 24-AS-20240729111516

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: VALLEY SPRING MEMORY CARE	FACILITY NUMBER: 247209172
	VISIT DATE: 11/18/2024

NARRATIVE

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3. The Department investigated the allegation: Staff does not ensure the facility is kept in clean sanitary conditions for residents in care. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not report the facility to be unclean or unsanitary. LPA toured the facility and did not observe the facility to be unclean or unsanitary.

4. The Department investigated the allegation: Staff does not ensure residents care needs are being met. LPA conducted multiple interviews with residents, staff members and third parties. Interviewees did not state the resident's needs are not being met.

5. The Department investigated the allegation: Staff does not ensure medications are dispensed as prescribed. LPA conducted multiple interviews with residents, staff members and third parties. None of the interviewees stated medications are not being dispensed as prescribed. LPA reviewed medications and did not find any deficiencies.

6. The Department investigated the allegation: Staff does not ensure residents records are properly managed. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not state resident's records are not be properly managed. LPA reviewed a sample of resident files.

7. The Department investigated the allegation: Staff does not ensure medications are properly stored. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees did not state resident's medications are not being properly stored. LPA observed medication room and did not observe any discrepancies.

8. The Department investigated the allegation: Staff does not ensure food of good quality is served to residents. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated the food is of good quality. Multiple interviewees stated they eat at the facility and the food is great. LPA observed the kitchen which had sufficient food supply, variety, and stored food properly.

9. The Department investigated the allegation: Staff does not ensure residents dietary plan is being followed. LPA conducted multiple interviews with residents, staff members, and third parties. Interviewees stated resident's dietary plans are being followed. LPA reviewed food plans and did not find any discrepancies.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was conducted and a copy of this report LIC9099 & LIC9099D were provided to Executive Director (ED) Krista Willson and Administrator (AD) Elizabeth Reynaga.

SUPERVISOR'S NAME: Brenda Chan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brianna Miranda	TELEPHONE: 559-770-0254
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2024

LIC9099 (FAS) - (06/04)

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