547209374-1-10-2026-24-AS-AWAN-DQJUC8-20260121142732

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 547209374
Report Date: 01/10/2026
Date Signed: 01/10/2026 01:36:54 PM

Unfounded

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
11/06/2025 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20251106212728

FACILITY NAME:	GRAND OAKS ASSISTED LIVING		FACILITY NUMBER:	547209374
ADMINISTRATOR:	SHELLHAMER, DAVID		FACILITY TYPE:	740
ADDRESS:	999 NORTH M STREET		TELEPHONE:	(559) 684-1001
CITY:	TULARE	STATE: CA	ZIP CODE:	93274
CAPACITY:	85	CENSUS: 66	DATE:	01/10/2026
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Administrator Alena Lema and Administrator David Shellhamer		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff neglected resident of goods and services.
Staff neglected resident of physical care.
Resident's health and safety endangered.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct a complaint investigation. LPA explained the purpose of the visit and was granted entry by Medication Technician Jessica Onsurez. Administrator Alena Lema and Administrator David Shellhamer responded to the facility to assist with the visit.

LPA obtained a copy of the staff roster. Based on records review there was not a staff listed on the staff roster that are listed in this complaint. Based on interviews, the facility has not received any residents from the skilled nursing facility that is listed in this complaint.

Based on LPA's interviews and record review, this agency has investigated the complaint alleging, Staff neglected resident of goods and services, Staff neglected resident of physical care and Resident's health and safety endangered. We have found that the complaint was UNFOUNDED, which means it could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint.
An exit interview was conducted and a copy of this report was provided.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2026

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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