107201156-6-22-2022-24-AS-MHON-CJVLKH-20221004084929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107201156
Report Date: 06/22/2022
Date Signed: 06/22/2022 01:18:16 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
06/14/2022 and conducted by Evaluator Malia Thao

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20220614100748

FACILITY NAME:	FAIRWINDS - WOODWARD PARK		FACILITY NUMBER:	107201156
ADMINISTRATOR:	VALERO, DESIREE		FACILITY TYPE:	740
ADDRESS:	9525 N FT WASHINGTON RD		TELEPHONE:	(559) 434-6444
CITY:	FRESNO	STATE: CA	ZIP CODE:	93730
CAPACITY:	270	CENSUS: 203	DATE:	06/22/2022
		UNANNOUNCED	TIME BEGAN:	11:41 AM
MET WITH:	Desiree Valero, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility failed to issue the full refund amount.

INVESTIGATION FINDINGS:

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On 6/22/22 at 9:16 AM Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct a complaint inspection. LPA checked in at front desk and met with Administrator (ADM) Desiree Valero. LPA explained reason for inspection.

LPA reviewed records and conducted interviews. LPA found that the facility issued a prorated refund to R1 for the dates of 5/27/22 through 5/31/22. R1 issued a written 30-day notice to vacate dated 4/24/22 to the facility front desk on 4/26/22. Facility noted the date of 4/27/22 as date notice was given by R1. Facility could not locate the written notice and did not record date of actual receipt of written notice by R1. S1 admitted the date of 4/27/22 is noted from another staff's verbal notice and did not receive or review the original written notice by R1. Therefore, the above allegation is unsubstantiated.

Exit interview conducted. A copy of this report was given to Administrator Desiree Valero, whose signature confirms receipt of this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Melinda Hoffmann	TELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Malia Thao	TELEPHONE: (559) 470-9001
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2022

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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