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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202817
Report Date: 01/19/2023
Date Signed: 01/22/2023 09:56:59 PM

Substantiated


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
01/11/2023 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 24-AS-20230111154422
FACILITY NAME:VISTA HARDEN RANCHFACILITY NUMBER:
275202817
ADMINISTRATOR:CARTER, JOYFACILITY TYPE:
740
ADDRESS:290 REGENCY CIRCLETELEPHONE:
(805) 319-7370
CITY:SALINASSTATE: CAZIP CODE:
93906
CAPACITY:83CENSUS: 68DATE:
01/19/2023
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Administrator, Joy HardenTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Staff not enforcing public health guidelines
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to open a complaint investigation. LPA Hurt met with facility Administrator Joy Carter and explained the purpose of today's visit.

Regarding the allegations Staff not enforcing public health guidelines. Based on interviews, and facility records reviewed the facility is not enforcing public health guidelines. LPA Hurt reviewed the facilities electronic file and found no incidents reported to Licensing of COVID positive cases at the facility. LPA Hurt also reviewed Community Care Licensing’s Share point online COVID tracking system and did not see any documented cases of COVID reported from the facility. LPA Hurt interviewed reporting party who stated they visited the facility on December 18, 2022 and signed in on the visitors log leaving all his contact information. Reporting party stated he did not receive a phone call informing him of the COVID positive outbreak that took place on December 20, 2022 despite visiting the facility two days prior.

Conitnued on 9099C....
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
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 3
Control Number 24-AS-20230111154422
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: VISTA HARDEN RANCH
FACILITY NUMBER: 275202817
VISIT DATE: 01/19/2023
NARRATIVE
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...Continued from 9099

LPA interviewed facility Administrator Joy Carter, and Resident Care Director Caitia Fajardo stated they did contact all responsible parties of COVID positive residents, but they did not contact visitors that signed in on facility visitation logs days prior.Therefore, this allegation is SUBSTANTIATED.


The following deficiencies are being cited Per Title 22 Regulations.

Exit interview conducted with facility Administrator Joy Carter and a copy of this report, along with appeals rights provided.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 24-AS-20230111154422
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: VISTA HARDEN RANCH
FACILITY NUMBER: 275202817
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
02/03/2023
Section Cited
CCR
87211(a)
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87211 Reporting Requirements
(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following:
(2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate. The following requirement has not been met as evidenced by:
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Administrator will conduct training with facility managers on reporting timeframes and procedures and submit proof to LPA by 02/03/2023.
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Based on interviews and records reviewed the facility did not report the COVID outbreak on December 20, 2022 to State Licensing or facility visitors which poses a potential health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3