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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208825
Report Date: 02/12/2024
Date Signed: 02/13/2024 07:36:04 AM

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
01/24/2024 and conducted by Evaluator Lisa Salazar
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240124083834
FACILITY NAME:PEOPLE'S CARE DAMSENFACILITY NUMBER:
547208825
ADMINISTRATOR:ALLEN, TARAFACILITY TYPE:
735
ADDRESS:6502 W DAMSEN AVETELEPHONE:
(559) 627-1281
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:4CENSUS: 3DATE:
02/12/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yadira Gamez, Administator
Jose Marquez, District Manager 		TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff neglected the hygiene needs of clients in care.
INVESTIGATION FINDINGS:
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On 02/12/24, Licensing Program Analysts (LPAs) L. Salazar and A Walton arrived at the facility unannounced to deliver findings on the above allegations. LPAs were greeted by current Administrator, stated the purpose of the visit and was allowed entry into the facility. District Manager arrived shortly after and joined in the visit.

LPA Salazar reviewed facility records and resident's file, there is documentation observed evidencing routine personal care for R1's nails was conducted and no documentation showing Administrator arranged for Podiatry care.

Based on the information received, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiency is being cited on the attached 9099-D.

An exit interview was conducted and a copy of this report and appeal rights were provided at the time of visit. A plan of correction was completed prior to LPA's visit. POC cleared.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
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 3
Control Number 24-AS-20240124083834
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: PEOPLE'S CARE DAMSEN
FACILITY NUMBER: 547208825
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/13/2024
Section Cited
CCR
80075(a)
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Health Related Services
(a) The licensee shall ensure that each client receives necessary first aid and other needed medical or dental services, including arrangement for and/or provision of transportation to the nearest available services.
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Administrator has created a body check binder and staff have received training from LVN how to conduct body checks. Podiatry appts are scheduled every 60 days for R1, R2 & R3. Next appointments are scheduled for 4/18/24. The 1st & 3rd Sunday of each month are scheduled for the LVN to file R1 & R2's nails, in between podiatry appointments. LPA observed MAR on file for scheduled trim. POC cleared.
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This requirement was not met as evidenced by LPAs records review. No evidence of Dr's visit's was observed to be scheduled or completed.
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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: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3