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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107202374
Report Date: 10/06/2023
Date Signed: 10/06/2023 01:34:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
05/01/2023 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20230501092207
FACILITY NAME:NEW LIGHT RESIDENTIAL CARE HOME, THEFACILITY NUMBER:
107202374
ADMINISTRATOR:GALVEZ, MARLENEFACILITY TYPE:
740
ADDRESS:1322 W. ROBERTS AVE.TELEPHONE:
(559) 261-9818
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 6DATE:
10/06/2023
UNANNOUNCEDTIME BEGAN:
12:58 PM
MET WITH:Administrator, Carlo SantosTIME COMPLETED:
01:48 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff lock residents in their rooms
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/6/2023 Licensing Program Analyst (LPA) M. Garza arrived at facility to deliver complaint findings. LPA met with Direct Care Staff, Bea Choua, explained reason for visit and was permitted entry into the facility. Administrator, Carlo Santos was contacted and arrived a short time later. A health and safety was completed for residents in care.

During investigation LPA completed interviews with staff and resident(s). Records reviewed indicated that 4 of 6 residents have been diagnosed with dementia and were unable to be interviewed. Interviews conducted with staff and resident(s) do not support the allegation. Although the allegation may or may not have occurred, the allegation above does not meet the preponderance of evidence standard per Title 22. The allegation is UNSUBSTANTIATED. No deficiencies cited during today’s visit.

Exit interview completed with Administrator, Carlo. A copy of this report was given.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023
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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