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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547200264
Report Date: 07/29/2021
Date Signed: 07/29/2021 12:15:10 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/03/2021 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20210503155428
FACILITY NAME:RIVERSEDGE ELDERCAREFACILITY NUMBER:
547200264
ADMINISTRATOR:PRESTAGE, MARY ELLENFACILITY TYPE:
740
ADDRESS:285 SOUTH WESTWOODTELEPHONE:
(559) 788-0611
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:6CENSUS: 0DATE:
07/29/2021
UNANNOUNCEDTIME BEGAN:
09:26 AM
MET WITH:Mary Ellen PrestageTIME COMPLETED:
10:02 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is not attending to residents in a timely manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Manager (LPM) M. Hoffmann and Licensing Program Analyst (LPA) M. Medina conducted a subsequent complaint visit on this date. LPA met with Licensee, Mary Ellen Prestage and stated purpose of visit.

LPA Medina conducted subsequent facility tour on this date. Based on the information gathered during the complaint investigation, interviews conducted and observation of LPA during complaint visit there is no evidence to prove or disapprove the allegation occurred.

This complaint allegations is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
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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