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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547206290
Report Date: 04/21/2026
Date Signed: 04/21/2026 12:13:10 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
11/25/2025 and conducted by Evaluator Les Xiong
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20251125124025
FACILITY NAME:KAISER SPECIALIZED RESIDENTIAL TAYLORFACILITY NUMBER:
547206290
ADMINISTRATOR:CARPENTER,EMILYFACILITY TYPE:
735
ADDRESS:2816 W TAYLOR AVETELEPHONE:
(559) 636-2590
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:4CENSUS: 4DATE:
04/21/2026
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Savanna ChambersTIME COMPLETED:
01:03 PM
ALLEGATION(S):
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Resident in care was physically abused.
INVESTIGATION FINDINGS:
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On 4/21/26, Licensing Program Analyst (LPA) L. Xiong arrived unannounced to deliver findings on the above allegation. LPA met with Administrator, Savanna Chambers.
Interviews revealed that that S1 was terminated on 11/19/2025 due to abuse. It was reported that R1 attempted to elope and S1 pulled R1’s backpack causing R1 to lose balance and fall to the ground.
Based on interviews, the preponderance of evidence standard has been met, therefore the allegation: Resident in care was physically abused is found to be SUBSTANTIATED.
A deficiency is being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached 9099D. An immediate civil penalty in the amount of $500 is being assessed on the attached LIC421IM
Exit interview conducted and a plan of correction was reviewed and developed with Savanna Chambers. A copy of the report and appeal rights were provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 24-AS-20251125124025
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: KAISER SPECIALIZED RESIDENTIAL TAYLOR
FACILITY NUMBER: 547206290
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/21/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/22/2026
Section Cited
CCR
80072(a)(3)
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80072 Personal Rights:(a)...each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature... This requirement was not met as evidenced by:
Based on interviews, the Licensee did not ensure the requirements for section 80072(a)(3) were met when S1 pulled R1’s backpack causing him to fall in an attempt to prevent R1 from eloping, which posses an immediate health and safety risk to residents in care.


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Licensee terminated the employment of S1. POC cleared during the inspection. Five hundred dollars ($500) Civil Penalty Assessed on lic 421IM.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026
LIC9099 (FAS) - (06/04)
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