547203298-3-24-2023-24-AS-SPIY-CQRL7Z-20230410083107

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 547203298
Report Date: 03/24/2023
Date Signed: 03/24/2023 05:27:33 PM

Unfounded

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
02/09/2023 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20230209130051

FACILITY NAME:	AUTUMN OAKS		FACILITY NUMBER:	547203298
ADMINISTRATOR:	ONG, ANTONIO G.		FACILITY TYPE:	740
ADDRESS:	848 N. JAYE STREET		TELEPHONE:	(559) 784-4144
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	44	CENSUS:	DATE:	03/24/2023
		UNANNOUNCED	TIME BEGAN:	04:12 PM
MET WITH:	Elizabeth Sanchez		TIME COMPLETED:	05:43 PM

ALLEGATION(S):

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Drugs are being used at the facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) L. Xiong conducted the complaint investigation visit to the facility. I met with Elizabeth Sanchez, Med. Tech and spoke Antonio Ong, Administrator on the phone informing them the purpose of the visit.

During the course of this investigation LPA interview staff/resident relevant to the complaint investigation. It was determined that the above allegation: Drugs are being used at the facility is UNFOUNDED. The investigation indicated there are no illegal drugs dropped off or being used at the facility. This agency has investigated the complaint alleging (Drugs are being used at the facility). We have found that the complaint was unfounded, therefore we have dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023

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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