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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547204082
Report Date: 10/20/2021
Date Signed: 10/21/2021 09:57:32 AM

Unsubstantiated


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
06/23/2021 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20210623091210
FACILITY NAME:ABARQUEZ HOMES INC.FACILITY NUMBER:
547204082
ADMINISTRATOR:ANDRES, RICARDOFACILITY TYPE:
735
ADDRESS:312 NW 4TH STREETTELEPHONE:
(559) 741-1296
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:4CENSUS: DATE:
10/20/2021
UNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Administrator Ricardo AndresTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
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5
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8
9
Resident's responsible person was not notified of residents change of condition.
Staff did not obtain timely medical treatment for resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Shawna Doucette contacted the facility to commence a complaint investigation. LPA conducted a visit and took COVID-19 pre-cautionary measures. LPA identified herself and explained the purpose of the visit was to deliver findings to Administrator Ricardo Andres.

LPA reviewed client file, medical records/doctor appointments, which show client was taken to the doctor on numerous occassions and responsible party was notified of change in condition.

Although the allegations Resident's responsible person was not notified of residents change of condition and
Staff did not obtain timely medical treatment for resident may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021
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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