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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 355202781
Report Date: 04/25/2024
Date Signed: 04/25/2024 11:44:22 AM

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
12/11/2023 and conducted by Evaluator David Ayers
COMPLAINT CONTROL NUMBER: 24-AS-20231211151804
FACILITY NAME:BAUTISTA HOMEFACILITY NUMBER:
355202781
ADMINISTRATOR:MITCHELL GUEVARAFACILITY TYPE:
737
ADDRESS:777 OLYMPIATELEPHONE:
(831) 818-7981
CITY:SAN JAUN BAUTISTASTATE: CAZIP CODE:
95045
CAPACITY:4CENSUS: 2DATE:
04/25/2024
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Mitchell Guevara - Program AdministratorTIME COMPLETED:
11:55 AM
ALLEGATION(S):
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Residents are neglected by staff
Resident is treated different than other residents
Medication records are incomplete
Staff are under the influence of drugs and/or alcohol at facility
Staff is stealing resident P&I funds
Staff engage in inappropriate sexual activity at facility
Staff are encouraged to lie to other agencies
INVESTIGATION FINDINGS:
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On 4/25/2024, Licensing Program Analyst (LPA) D. Ayers conducted an unannounced complaint inspection. LPA met with Program Administrator Mitchell Guevara and announced the purpose of the inspection. The purpose of this visit is to deliver the finding of the investigation completed by the Department. 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. During the course of the investigation, the department inspected the facility, conducted interviews, and reviewed records. The following allegations have been determined to be Unsubstantiated:

1) Residents are neglected by staff: During interviews, facility staff denied that any residents have been neglected. Representatives from the local placement agency reported that they do not have any concerns of neglect. During multpile facility inspections, there were no indications of neglect by staff.

2) Residents are treated different than other residents: Because residents have different interests nand respond to activities differently, some residents attend certain outings or participate in ceratin activities while other do not.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: David Ayers
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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-20231211151804
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: BAUTISTA HOME
FACILITY NUMBER: 355202781
VISIT DATE: 04/25/2024
NARRATIVE
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3) Medication records are incomplete: During facility inspections and record reviews conducted on 10/27/2023, 12/15/2023, and 2/22/2024, medications records were complete and medications appeared to be administered properly.

4) Staff are under the influence of drugs and/or alcohol at facility: During interview, multiple staff members denied witnessing or hearing of any staff being under the influence of drugs or alcohol while at the facility. During Inspections, there were no indications that facility staff use drugs or alcohol while at the facility.

5) Staff is stealing resident P&I funds: During inspections on 10/27/2023, 12/15/2023, and 2/22/2024, resident P&I funds matched records of withdraws and receipts for purchases. Staff denied that any staff have stolen resident P&I funds.

6) Staff engage in inappropriate sexual activity at facility: During interview, staff denied hearing of any staff engaging in inappropriate sexual activity. facility Licensee and Administrator conducted their own investigation into allegations of inappropriate sexual activity.

7) Staff are encouraged to lie to other agencies: During interviews, staff members denied that they are encouraged to lie to other agencies.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. No deficiencies were cited during the inspection. A copy of the report was provided and exit interview conducted.
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: David Ayers
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2