<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208243
Report Date: 08/04/2023
Date Signed: 08/04/2023 12:57:08 PM

Substantiated


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
04/27/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230427164255
FACILITY NAME:ENCLAVE AT THE FOOTHILLSFACILITY NUMBER:
547208243
ADMINISTRATOR:PEREZ, KRISTINAFACILITY TYPE:
735
ADDRESS:10650 ROAD 256TELEPHONE:
(559) 527-5091
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY:100CENSUS: 14DATE:
08/04/2023
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Laura Li, Chief Administrative OfficerTIME COMPLETED:
12:47 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staffing is insufficient to meet the needs of residents
Staff are not properly trained
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/04/23, Licensing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) M. Hoffmann conducted a subsequent visit to deliver findings to complaint. LPA and LPM met with Laura Li, Chief Administrative Officer.

During the investigation, LPA Medina conducted interviews and reviewed records. The allegations that staffing is not sufficient to meet the needs of residents and staff training is insufficient are SUBSTANTIATED.

Based on records review, staff are not properly trained, resulting in staffing being insufficient to meet the needs of residents in care, specifically related to mental illness.

Deficiency cited in the attached 9099D for violation of Title 22, Division 6, Chapter 1, Article 06, Section 80065.

Appeal rights provided, and exit interview conducted with Chief Administrative Officer, Laura Li.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
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 4
Control Number 24-AS-20230427164255
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ENCLAVE AT THE FOOTHILLS
FACILITY NUMBER: 547208243
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/18/2023
Section Cited
CCR
80065(f)
1
2
3
4
5
6
7
All personnel shall be given on-the-job training or shall have related experience which provides knowledge of and skill in the following areas, as appropriate to the job assigned and as evidenced by safe and effective
1
2
3
4
5
6
7
Facility will provide all related training documents to Fresno Regional Office no later than POC due date.
8
9
10
11
12
13
14
job performance... ***This requirement was not met when record review revealed that staff do not have sufficient training, resulting in staffing being insufficient to meet the needs of residents in care. This poses a potential risk to the health, safety, or personal rights of residents in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
04/27/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230427164255

FACILITY NAME:ENCLAVE AT THE FOOTHILLSFACILITY NUMBER:
547208243
ADMINISTRATOR:PEREZ, KRISTINAFACILITY TYPE:
735
ADDRESS:10650 ROAD 256TELEPHONE:
(559) 527-5091
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY:100CENSUS: 14DATE:
08/04/2023
UNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Laura Li, Chief Administrative OfficerTIME COMPLETED:
12:47 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is unclean and in disrepair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/04/23, Licensing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) M. Hoffmann conducted a subsequent visit to deliver findings to complaint. LPA and LPM met with Laura Li, Chief Administrative Officer.

The Department investigated the complaint that facility is unclean and in disrepair and based on tour of resident rooms, they were lived in but not observed to be dirty. Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove or disprove the allegation occurred therefore the complaint is UNSUBSTANTIATED.

No deficiencies cited. Exit interview conducted with Chief Administrative Officer.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4