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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208243
Report Date: 08/28/2023
Date Signed: 08/28/2023 12:11:32 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
08/03/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230803165600
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: 9DATE:
08/28/2023
UNANNOUNCEDTIME BEGAN:
11:19 AM
MET WITH:Javier HernandezTIME COMPLETED:
12:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/28/2023, Licensing Program Analyst (LPA) M. Medina and Licensing Program Manager (LPM) M. Hoffmann arrived to conduct a subsequent complaint visit and deliver findings. LPA Medina and LPM Hoffman met with Administrator, Javier Hernandez and stated purpose of visit.

During the visit, LPA conducted interview with S1.

During course of the investigation, interviews were conducted with R1, S1, and S2. R1 stated that S1 and S2 spoke inappropriately to R1 however S1 and S2 denied doing so. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or disprove that allegation occurred therefore the allegation is unsubstantiated.

No deficiencies cited.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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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