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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 277209489
Report Date: 08/25/2025
Date Signed: 08/26/2025 12:47:34 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
07/07/2025 and conducted by Evaluator Vadim Gorban
COMPLAINT CONTROL NUMBER: 24-AS-20250707165437
FACILITY NAME:COTTAGES OF CARMELFACILITY NUMBER:
277209489
ADMINISTRATOR:ESTRELLADO, JULE MAYFACILITY TYPE:
740
ADDRESS:26245 CARMEL RANCHO BLVD.TELEPHONE:
(831) 620-1800
CITY:CARMELSTATE: CAZIP CODE:
93923
CAPACITY:78CENSUS: 54DATE:
08/25/2025
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:administrator Nelson RubioTIME COMPLETED:
01:55 PM
ALLEGATION(S):
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9
Staff did not ensure that resident's toileting needs were met.
Staff did not seek medical attention for resident in a timely manner.
Facility is not adhering to infectious control protocols.
INVESTIGATION FINDINGS:
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13
On 08/25/2025, Licensing Program Analyst (LPA) V Gorban conducted subsequent complaint inspection. LPA met with administrator Nelson Rubio. The purpose of this visit is to deliver the findings of the investigation completed by the Department.
During the visit, LPA conducted a tour of the facility, interior and exterior to ensure there are no potential or immediate health and safety risk at the facility.
Regarding Staff did not ensure that resident's toileting needs were met. Based on observations and interviews no concerns reported or observed regarding patient care. Based on interviews, staff check on residents every two hours.
Regarding Staff did not seek medical attention for resident in a timely manner. Based on interviews and record reviews resident R1 was taken to the hospital and responsible party was notifies on the day of the incident, May 11th, 2025.

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

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
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 2
Control Number 24-AS-20250707165437
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: COTTAGES OF CARMEL
FACILITY NUMBER: 277209489
VISIT DATE: 08/25/2025
NARRATIVE
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Regarding Facility is not adhering to infectious control protocols. Based on observations facility have substantial amount of PPE, based on interviews and records reviews, facility infection control requirements files are up to date.
Although the allegations may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations are UNSUBSTANTIATED.

Exit interview was conducted, and a copy of this report provided to administrator for facility records.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2