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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547208880
Report Date: 03/21/2023
Date Signed: 03/21/2023 11:53:04 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
12/07/2022 and conducted by Evaluator Malia Thao
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20221207161724
FACILITY NAME:PEOPLE'S CARE MARLINFACILITY NUMBER:
547208880
ADMINISTRATOR:BUTLER, SHARONFACILITY TYPE:
735
ADDRESS:12744 MARLIN AVETELEPHONE:
(559) 372-8827
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:4CENSUS: 4DATE:
03/21/2023
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Tara Allen, AdministratorTIME COMPLETED:
10:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Inappropriate restraint by staff caused injury to client
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/21/23 at 8:50 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint inspection. LPA explained reason for inspection and was granted entry by staff. Administrator Tara Allen arrived a short time later.

LPA conducted interviews and reviewed records. Based on record review and interviews, there was not sufficient evidence to show inappropriate restraint by staff caused injury to client. The above allegation is unsubstantiated. The allegations may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred.

Exit interview conducted. A copy of this report was given to Administrator Tara Allen, whose signature confirms receipt of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
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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