547209193-12-8-2022-24-AS-SPIY-CM3LRY-20221213075955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 547209193
Report Date: 12/08/2022
Date Signed: 12/08/2022 06:48:02 PM

Unfounded

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
12/05/2022 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20221205113922

FACILITY NAME:	MAGNOLIA PARK ASSISTED LIVING		FACILITY NUMBER:	547209193
ADMINISTRATOR:	GIBSON, ERNEST G.		FACILITY TYPE:	740
ADDRESS:	2950 E. DOUGLAS AVE		TELEPHONE:	(559) 625-6001
CITY:	VISALIA	STATE: CA	ZIP CODE:	93292
CAPACITY:	59	CENSUS:	DATE:	12/08/2022
		UNANNOUNCED	TIME BEGAN:	04:21 PM
MET WITH:	Meshell Ramos		TIME COMPLETED:	07:07 PM

ALLEGATION(S):

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Staff is intoxicated on the facility grounds
Staff sleeps at the facility
Uncleared staff is present at the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) L. Xiong conducted the complaint investigation visit to the facility. I met with Meshell Ramos, Executive Director and informed her the purpose of the visit.

During the course of this investigation LPA reviewed facility files and spoke to staff and resident relevant to the complaint investigation. It was determined that the above allegation: Staff is intoxicated on the facility grounds, Staff sleeps at the facility, and Uncleared staff is present at the facility are UNFOUNDED. The investigation indicated no issue with staff sleeping on the joab, day or night. Staff were not observed coming to work intoxicated, and staffs were fingerprint cleared. This agency has investigated the complaint alleging (Staff is intoxicated on the facility grounds, Staff sleeps at the facility, and Uncleared staff is present at the facility). We have found that the complaint was unfounded, therefore we have dismissed the complaint.

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Les Xiong	TELEPHONE: (559) 410-1772
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022

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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