500306146-6-1-2023-27-AS-KHOS-CU5GWW-20230727054302

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 500306146
Report Date: 06/01/2023
Date Signed: 06/01/2023 02:35:38 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
03/24/2023 and conducted by Evaluator Jason Lund

COMPLAINT CONTROL NUMBER: 27-AS-20230324082757

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: 84	DATE:	06/01/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Le Ann Blocker Resident Coordinator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility has bed bugs.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Jason Lund arrived unannounced to complete a complaint investigation regarding the above allegation. LPA Lund met with Le Ann Blocker Resident Coordinator and explained the reason for the visit.

Facility has bed bugs-LPA Lund reviewed facility records, interviewed staff and residents in care. LPA Lund reviewed the Clark Pest Control facility service history from 4/20/2023 through 6/1/2023 stating the facility has pest control service at the facility weekly. LPA Lund didn’t observe any bed bugs during the complaint investigation.

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: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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 27-AS-20230324082757

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: 06/01/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on facility records review, observation, interviews with staff and residents on the information provided, it was unclear if facility has bed bugs, therefore the allegation was deemed UNSUBSTANTIATED.

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.

SUPERVISOR'S NAME: Stephenie Doub	TELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason Lund	TELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2