107206544-12-22-2021-24-AS-SPIY-CCTRX3-20220324132405

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107206544
Report Date: 12/20/2021
Date Signed: 12/22/2021 09:05:24 AM

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
06/01/2021 and conducted by Evaluator Mary Garza

COMPLAINT CONTROL NUMBER: 24-AS-20210601152413

FACILITY NAME:	REHABILITATION CENTRE OF FRESNO		FACILITY NUMBER:	107206544
ADMINISTRATOR:	BAINS, AMAN		FACILITY TYPE:	740
ADDRESS:	1665 M ST		TELEPHONE:	(559) 268-5361
CITY:	FRESNO	STATE: CA	ZIP CODE:	93721
CAPACITY:	70	CENSUS: 32	DATE:	12/20/2021
		UNANNOUNCED	TIME BEGAN:	01:09 PM
MET WITH:	Administrator, Aman Bains		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff provide medications to residents without updated physician orders.
Staff falsify physician's orders.
Residents' service plans are not updated as necessary.

INVESTIGATION FINDINGS:

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On 12/20/2021 Licensing Program Analyst (LPA) conducted an unannounced visit to deliver complaint findings in the above allegations. LPA identified self and discussed the purpose of the visit with Administrator, Aman Bains. LPA conducted Health and Safety check on residents in care.

The Department has investigated the allegations above. Based on interviews conducted and record/medical review(s), the Department concluded that the allegations may have happened or is valid, however there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBTANTIATED. Exit interview completed with Administrator.

Due to COVID precautionary measures a copy of this report will be emailed to: administrator.al@hcfresno.com
A delivered and read receipt serves as confirmation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

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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