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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208243
Report Date: 06/22/2023
Date Signed: 06/22/2023 02:17:32 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
06/16/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230616144452
FACILITY NAME:ENCLAVE AT THE FOOTHILLSFACILITY NUMBER:
547208243
ADMINISTRATOR:HERNANDEZ, JAVIERFACILITY TYPE:
735
ADDRESS:10650 ROAD 256TELEPHONE:
(559) 527-5091
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY:100CENSUS: 17DATE:
06/22/2023
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Javier Hernandez
David Shellhamer		TIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not treat a client with dignity and respect
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/22/2023, Licensing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) M. Hoffmann arrived to conduct an unannounced Complaint visit. LPA Medina informed Administrator, Javier Hernandez and Director of Residential Services, David Shellhamer of purpose of visit.

During the visit, R1 was interviewed and did not mention S1 or any other staff called R1 inappropriate names. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or disprove that that allegation occurred therefore the allegation is unsubstantated.

No deficiencies cited.

Exit interview conducted and a copy of report provided for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023
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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