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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547203972
Report Date: 11/26/2024
Date Signed: 11/26/2024 01:37:43 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
05/30/2024 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240530163703
FACILITY NAME:CENTRAL VALLEY TRAINING CENTERFACILITY NUMBER:
547203972
ADMINISTRATOR:DEVRIES, LINDSEYFACILITY TYPE:
775
ADDRESS:9838 W. GROVE AVETELEPHONE:
(559) 651-2844
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:75CENSUS: DATE:
11/26/2024
UNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Program Director Crystal AkeredoluTIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff engaged in a physical altercation with client in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/26/24 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver the finding for the allegation(s) listed above. LPA introduced herself, explained the reason for the visit, and met with Program Director Crystal Akeredolu

1. The Department investigated the allegation: Staff engaged in a physical altercation with client in care. Multiple interviews were conducted. Interviewees stated C1 was having a behavior attempted to hit S1, when C1 slipped and fell.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated

Exit interview was conducted and a copy of this report LIC9099 was provided to Program Director Crystal Akeredolu
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
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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