547206331-10-20-2022-24-AS-MHON-CKHL8U-20221024083227

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 547206331
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:56:21 PM

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
06/20/2022 and conducted by Evaluator Melinda Medina

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220620102853

FACILITY NAME:	RUF ADULT RESIDENTIAL		FACILITY NUMBER:	547206331
ADMINISTRATOR:	RUF, AMY		FACILITY TYPE:	735
ADDRESS:	940 NORTH BELMONT STREET		TELEPHONE:	(559) 784-4657
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	5	CENSUS: 3	DATE:	10/20/2022
		UNANNOUNCED	TIME BEGAN:	01:19 PM
MET WITH:	Jessica Gomez		TIME COMPLETED:	03:10 PM

ALLEGATION(S):

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Facility staff spoke aggressively and disrespectfully to resident
Reporting party alleges staff punished resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) M. Medina conducted a subsequent visit to facility to conduct interviews. LPA identified herself and discussed the purpose of visit with
Licensee, Amy Ruf via telephone. LPA allowed entrance by Caregiver.

LPA conducted interviews with Resident (R1) and Staff (S1, S2, S3). LPA was unable to interview alleged witness (W1) resulting in insufficient information regarding allegations of facility staff spoke aggressively and disrespectfully to resident and alleging staff punished resident, .

Although the allegation 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 allegations are UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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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