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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275202817
Report Date: 01/24/2024
Date Signed: 02/06/2024 11:00:58 AM

Unsubstantiated


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
08/29/2023 and conducted by Evaluator Sarah Hurt
COMPLAINT CONTROL NUMBER: 24-AS-20230829083953
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: 71DATE:
01/24/2024
UNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Administrator, Joy Carter TIME COMPLETED:
06:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident sustained unexplained injury in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA's) Sarah Hurt and Lisa Salazar conducted an unannounced facility visit deliver findings on the above allegations. LPA met with facility Administrator, Joy Carter over the phone and explained the purpose of today's visit.

Regarding the allegation Resident sustained unexplained injury in care. Facility Resident 1 did sustain an unexplained injury at the facility on 08/14/23. The facility did seek medical care for Resident 1 in a timely manner. LPA reviewed Resident`R1's Physicians report that does not indicate R1 is in need of 1:1 staffing. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficincies cited Per 22 Regulations. Exit interview conducted with Administrator, Joy Carter, and a copy of this report left at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024
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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