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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547209145
Report Date: 11/17/2021
Date Signed: 11/17/2021 03:21:36 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
11/09/2021 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20211109115732
FACILITY NAME:RICO RESIDENTIAL FACILITY #4FACILITY NUMBER:
547209145
ADMINISTRATOR:RICO, DIANA O.FACILITY TYPE:
735
ADDRESS:829 S. COTTAGE STTELEPHONE:
(559) 791-1325
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:6CENSUS: 5DATE:
11/17/2021
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Diana Rico, AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff left a client soiled while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) M. Yang conducted an initial complaint investigation on this date and met with Administrator. LPA stated the purpose of the visit and reviewed the allegation.

During the course of the investigation, the Department conducted interviews and toured the facility. LPA interviewed client, staffs, and Administrator. Based on the interviews conducted, the client, staffs, and Administrator confirmed the client gets cleaned after every bowel movements.

Based on interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegations are found to be UNSUBSTANTIATED.

Exit interview conducted. As a COVID-19 precautionary measure, a copy of this report will be provided via email. Report signed on-site.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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 2