500306146-2-3-2023-27-AS-SRIN-CPJ4DB-20230301180029

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 500306146
Report Date: 02/03/2023
Date Signed: 02/03/2023 01:44:20 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2022 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20220817104026

FACILITY NAME:	LAS PALMAS ESTATES		FACILITY NUMBER:	500306146
ADMINISTRATOR:	MILLER, KREGG		FACILITY TYPE:	740
ADDRESS:	1617 COLORADO		TELEPHONE:	(209) 632-8841
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	89	CENSUS: 85	DATE:	02/03/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Le Ann Blocker Resident Coordinator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Facility is not taking preventative measures to address bed bugs

INVESTIGATION FINDINGS:

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On 2/3/2023, Licensing Program Analyst (LPA) Jason Lund arrived at the facility unannounced to complete a complaint investigation regarding the above allegations. LPA Lund meet with Le Ann Blocker Resident Coordinator and explained the reason for the visit.
Facility is not taking preventative measures to address bed bugs-LPA Lund reviewed facility records, interviewed staff and residents in care. LPA Lund reviewed the Clark Pest Control facility service history from 12/01/2021 through 11/17/2022 stating the facility has pest control service at the facility.
Based on facility records review, clients and staff interviews on the information provided, it was unclear if facility is not taking preventative measures to address roaches therefore the allegation was deemed UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

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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Control Number 27-AS-20220817104026

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833

FACILITY NAME: LAS PALMAS ESTATES	FACILITY NUMBER: 500306146
	VISIT DATE: 02/03/2023

NARRATIVE

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As a result of this investigation, this Department finds the allegation to be UNSUBSTANTIATED. A complaint allegation finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Exit interview was conducted with Le Ann Blocker Resident Coordinator and a copy of report was left along with a copy of the appeal rights.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023

LIC9099 (FAS) - (06/04)

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