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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202077
Report Date: 09/26/2023
Date Signed: 09/28/2023 04:56:26 AM

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
06/01/2023 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230601135723
FACILITY NAME:SVS MARINA ADULT DAY PROGRAMFACILITY NUMBER:
275202077
ADMINISTRATOR:RITA FAATUAIFACILITY TYPE:
775
ADDRESS:330 RESERVATION RD. STE. DTELEPHONE:
(831) 582-2961
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY:60CENSUS: 34DATE:
09/26/2023
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator- RITA FAATUAITIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not follow IPP for client in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/26/23 at 10:05 a.m. Licensing Program Analyst B. Miranda arrived at the facility unannounced to deliver the finding for the allegations listed above. LPA introduced herself and explained the reason for the visit. Administrator (AD) RITA FAATUAI was contacted.
1. The Department investigated the allegation: Staff do not follow IPP for client in care. LPA reviewed sample of IPP's which did not indicate there was a staff to client ratio. LPA also interviewed staff who stated IPP's are followed and there is adequate staff for the facility.

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 was printed and given to administrator RITA FAATUAI
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2023
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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