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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 275294324
Report Date: 05/13/2025
Date Signed: 05/14/2025 03:30:09 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
04/02/2025 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250402111401
FACILITY NAME:FLANDERS COURT OF CARMEL, LLCFACILITY NUMBER:
275294324
ADMINISTRATOR:HAGERTY, MICHAELFACILITY TYPE:
740
ADDRESS:25661 MORSE DRIVETELEPHONE:
(831) 626-0824
CITY:CARMELSTATE: CAZIP CODE:
93923
CAPACITY:6CENSUS: 6DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
10:36 AM
MET WITH:Administrator Michael HagertyTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Ramp at the facility is missing
Facility's roof is leaking
Facility uses resident's room for storage
INVESTIGATION FINDINGS:
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On 05/13/2025, Licensing Program Analyst (LPA) V. Gorban conducted an unannounced subsequent complaint investigation to deliver findings. LPA explained the purpose of visit and toured the facility with Administrator Michael Hagerty.
During the course of the investigation, LPA conducted a facility tour, interviewed residents and reviewed records.
The Department has investigated the allegation: Ramp at the facility is missing. During the facility visit LPA toured each resident room and observed the foundation is single level. Based on records review and staff interviews no concerns of missing ramp observed or reported. 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 Ramp at the facility is missing, is UNSUBSTANTIATED.

Report continues on attached LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
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 5
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
04/02/2025 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250402111401

FACILITY NAME:FLANDERS COURT OF CARMEL, LLCFACILITY NUMBER:
275294324
ADMINISTRATOR:HAGERTY, MICHAELFACILITY TYPE:
740
ADDRESS:25661 MORSE DRIVETELEPHONE:
(831) 626-0824
CITY:CARMELSTATE: CAZIP CODE:
93923
CAPACITY:6CENSUS: 6DATE:
05/13/2025
UNANNOUNCEDTIME BEGAN:
10:36 AM
MET WITH:TIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Appliance at the facility is not working properly including dishwasher and refrigerator
Facility has expired food for resident
INVESTIGATION FINDINGS:
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3
4
5
6
7
8
9
10
11
12
13
On 05/13/2025, Licensing Program Analyst (LPA) V. Gorban conducted an unannounced subsequent complaint investigation to deliver findings. LPA explained the purpose of visit and toured the facility with Administrator Michael Hagerty.
During the course of the investigation, LPA conducted a facility tour, interviewed residents and reviewed records.
The Department has investigated the allegation: Appliance at the facility is not working properly including dishwasher and refrigerator. On 04/10/2025, LPA interviewed facility staff and administrator stating dishwasher was broken. Based on observations, interviews conducted, and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A deficiency is being issued in accordance with California Code of Regulations, Title 22, on the attached 9099-D.

Report continues on attached LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 24-AS-20250402111401
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: FLANDERS COURT OF CARMEL, LLC
FACILITY NUMBER: 275294324
VISIT DATE: 05/13/2025
NARRATIVE
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The Department has investigated the allegation: Facility has expired food for resident. During facility visit on 4/10/25 LPA observed frozen food section in the freezer that is expired. Based on observations, interviews conducted, and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A deficiency is being issued in accordance with California Code of Regulations, Title 22, on the attached 9099-D.

Deficiencies were cited during this visit.

Exit interview conducted, report signed and copy of this report with appeal rights provided to Administrator for facility records.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 24-AS-20250402111401
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: FLANDERS COURT OF CARMEL, LLC
FACILITY NUMBER: 275294324
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2025
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors. This requirement was not observed as evidenced by:
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The Administrator agrees to provide proof of functional dishwasher, Proof of correction to be provide to LPA by email by POC due date.
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Based on observation sand records review the facility dishwasher in the kitchen was not functional due to unknown broken part. This is poses potential health and safety risk to persons in care.
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Type B
05/16/2025
Section Cited
CCR
87555(a)
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87555 General Food Service Requirements. (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. This requirement was not observed as evidenced by:
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The Administrator agrees to discard expired food with expiration date past due. Proof of correction of the quality food stored to be provide to LPA by email by POC due date.
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Based on observations and interview the staff kept in the facility freezers variety of expired food in the for residents consumption. This poses potential health and safety risk to persons 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.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 24-AS-20250402111401
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: FLANDERS COURT OF CARMEL, LLC
FACILITY NUMBER: 275294324
VISIT DATE: 05/13/2025
NARRATIVE
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The Department has investigated the allegation: Facility's roof is leaking. During complaint investigation LPA toured the facility, interviewed administrator, staff and residents. During the facility visits on March 27th and April 10th LPA did not observe roof leaks. Administrator response to interview was that roof leaks were observed from skylight in hallway outside room 4 earlier this year and repaired prior to facility visit. Based on files review indicated small opening of dry wall in room 4 and room 5 due to facility planned to review structures of the stucco for beams trucking and evaluations. 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: Facility’s roof is leaking, is UNSUBSTANTIATED.

The Department has investigated the allegation: Facility uses resident's room for storage. Based on observation during facility visit on 4/10/25 and staff interview, each resident room, bathroom and closet stored only residents’ personal belongings and residents personal care products. 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: Facility’s roof is leaking, is UNSUBSTANTIATED.

Exit interview conducted, report signed and copy of this report provided to Administrator for facility records.

SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5