547202809-12-12-2022-24-AS-SMOA-CM5V3B-20221215150427

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 547202809
Report Date: 12/12/2022
Date Signed: 12/12/2022 03:06:47 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
09/08/2022 and conducted by Evaluator Kamaldeep Kaur

COMPLAINT CONTROL NUMBER: 24-AS-20220908143946

FACILITY NAME:	TRANSITIONAL LIVING CENTER		FACILITY NUMBER:	547202809
ADMINISTRATOR:	LEIGH (CABEJE), TAMARA		FACILITY TYPE:	735
ADDRESS:	546 E. TULARE AVENUE		TELEPHONE:	(559) 733-6648
CITY:	VISALIA	STATE: CA	ZIP CODE:	93292
CAPACITY:	38	CENSUS: 31	DATE:	12/12/2022
		UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Lead Case Manager Ignacio Garcia		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Resident was assaulted by another resident due to lack of care/supervision
Facility failed to contact law enforcement immediately

INVESTIGATION FINDINGS:

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On 12/12/22, Licensing Program Analyst (LPA) K. Kaur arrived unannounced to deliver findings. LPA met with Lead Case Manager Ignacio Garcia and announced the purpose of the visit. LPA discussed the elements of the allegations with Administrator Tamara Leigh over the phone.

The Department investigated the allegations listed above. Interviews were conducted with staff and residents. LPA reviewed documents submitted by facility and the police report. When staff became aware of the incident they intervened, and law enforcement was contacted upon the request of the parties involved. Based on observation and interview of staff and residents, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur, therefore these allegations are unsubstantiated.

An exit interview was conducted. Report signed on site by Lead Case Manager Ignacio Garcia and printed copy provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022

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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