<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202604
Report Date: 12/10/2024
Date Signed: 12/20/2024 01:54:22 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 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
12/04/2024 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 24-AS-20241204145107
FACILITY NAME:REINDOLLAR ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
275202604
ADMINISTRATOR:ADLER, WENDYFACILITY TYPE:
735
ADDRESS:301 REINDOLLAR AVETELEPHONE:
(831) 372-8002
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY:4CENSUS: 4DATE:
12/10/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator, Wendy AdlerTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are falsifying resident records
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to deliver findings on the allegations listed above . LPA met with facility Administrator, Wendy Adler, and explained the purpose of today's visit.

Regarding the allegation Facility staff are falsifying resident records. Facility staff 1 documented Resident 1's medication was given at 7 a.m. Resident 1 was sleeping at 7 a.m. and medication was not given until 10 a.m. Resident 1's medication instructions document to be given at 7a.m. Based on interviews, and documents reviewed the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The following deficincies are being cited Per Title 22 Regulations.

Exit interview conducted with facility Administrator Wendy Adler, and a copy of this report along with appeals rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
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-20241204145107
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: REINDOLLAR ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 275202604
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/24/2024
Section Cited
CCR
87465(a)(2)
1
2
3
4
5
6
7
87465Incidental Medical and Dental Care (a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following:

(1) The licensee shall arrange, or assist in arranging, for medical and dental care appropriate to the conditions and needs of residents.(2) The licensee shall provide assistance in meeting necessary medical and dental needs. This includes transportation which may be limited to the nearest available medical or dental facility which will meet the resident's need. In providing transportation the licensee shall do so directly or make arrangements for this service.

(3) When residents require prosthetic devices, vision and hearing aids, the staff shall be familiar with the use of these devices, and shall assist such persons with their utilization as needed.(4) The licensee shall assist residents with self-administered medications as needed. The following requirements are not met as evidenced by:
1
2
3
4
5
6
7
Administrator will provide training to facility staff on medication administration, and send proof to LPA by POC date of 12/24/2024.
8
9
10
11
12
13
14
Resident 1 was not given 7am medications as he was sleeping, the medication was already documented as given by facility staff, which is a potential, health, safety, or personal rights risk to residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2