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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107203515
Report Date: 05/04/2023
Date Signed: 05/04/2023 02:40:13 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
03/17/2023 and conducted by Evaluator Alexandria Walton
COMPLAINT CONTROL NUMBER: 24-AS-20230317104555
FACILITY NAME:RUBY'S VALLEY CARE HOMEFACILITY NUMBER:
107203515
ADMINISTRATOR:ANTHONY BEASLEYFACILITY TYPE:
735
ADDRESS:9919 SOUTH ELM AVE.TELEPHONE:
(559) 834-6038
CITY:FRESNOSTATE: CAZIP CODE:
93706
CAPACITY:50CENSUS: 43DATE:
05/04/2023
UNANNOUNCEDTIME BEGAN:
02:22 PM
MET WITH:Assistant Administrator, Anthony Beasley Jr., Program Administrator, Shanae Bishop, and Operations Administrator, Allyson Dearmond.TIME COMPLETED:
02:53 PM
ALLEGATION(S):
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Staff are under the influence of drugs while on shift
Client rooms are not kept clean
INVESTIGATION FINDINGS:
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On 05/04/2023, Licensing Program Analyst (LPA) A. Walton arrived at the facility unannounced to deliver findings on the above allegations. LPA introduced self and stated the purpose of the visit and was allowed to enter the facility. LPA met with Assistant Administrator, Anthony Beasley, Program Administrator, Shanae Bishop, and Operations Administrator, Allyson Dearmond.

LPA conducted a facility tour and observed residents rooms to be clean and pathways were clear of obstructions. Residents rooms had required furnishings and adequate lighting available.

Interviews with Administrators revealed that the facility had suspected 3 facility staff of being under the influence of a substance prior to staff begining the assigned shift. CONTINUED TO 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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
Control Number 24-AS-20230317104555
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: RUBY'S VALLEY CARE HOME
FACILITY NUMBER: 107203515
VISIT DATE: 05/04/2023
NARRATIVE
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Facility has a zero tolerance policy for staff providing care while under the influence of any substance. The suspected staff were removed from the facility and have not returned.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to Assistant Administrator, Anthony Beasley, Jr., whose signature on this form confirms receipt of this documents
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2