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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547206282
Report Date: 06/07/2023
Date Signed: 06/07/2023 02:54:49 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
02/21/2023 and conducted by Evaluator Kamaldeep Kaur
COMPLAINT CONTROL NUMBER: 24-AS-20230221155220
FACILITY NAME:PIRA HOME CAREFACILITY NUMBER:
547206282
ADMINISTRATOR:PIRA, JOSE A, JR.FACILITY TYPE:
735
ADDRESS:4222 S. ROVA STTELEPHONE:
(559) 739-7030
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:4CENSUS: 4DATE:
06/07/2023
UNANNOUNCEDTIME BEGAN:
01:31 PM
MET WITH:Licensee Jose PiraTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Clients sustained unexplained bruising while in care due to licensee neglect
Staff do not ensure clients' hygiene needs are being met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/7/2023, Licensing Program Analyst (LPA) K. Kaur arrived unannounced to deliver findings. LPA explained reason for inspection and was granted entry by staff. LPA met with Licensee; Jose Pira who arrived a short time later. LPA discussed the elements of the allegations with the Licensee

The Department investigated the allegations listed above. The Department conducted interviews, reviewed records, and made observations. Based on observations, interviews conducted, and records reviewed, there was not sufficient evidence to indicate staff do not ensure clients' hygiene needs are being met or that clients sustained unexplained bruising while in care. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did occur; therefore, the allegations are UNSUBSTANTIATED.

Exit interview conducted with Licensee. A copy of this report was signed and given to Licensee, whose signature confirms receipt of this report.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2023
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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