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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107207113
Report Date: 07/15/2025
Date Signed: 07/15/2025 12:22:13 PM

Substantiated


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
07/14/2025 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20250714101422
FACILITY NAME:BONAVENTE HOME FOR THE ELDERLY #2FACILITY NUMBER:
107207113
ADMINISTRATOR:BONAVENTE, NIDAFACILITY TYPE:
740
ADDRESS:6097 HARRISONTELEPHONE:
(559) 313-9052
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 6DATE:
07/15/2025
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Direct Care Staff (Designee), Leticia Aldana.TIME COMPLETED:
12:29 PM
ALLEGATION(S):
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Staff did not ensure there was sufficient foods available at the facility for residents in care
INVESTIGATION FINDINGS:
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On 7/15/25 Licensing Program Analyst, Mary Garza arrived at the facility for an unannounced initial complaint visit. LPA met with Direct Care Staff, Leticia Aldana, explained reason for visit and was permitted entry into the faclity. Administrator, RoseMarie Riemer was contacted and arrived some time later. LPA completed a health and safety check on residents in care and a tour of the faciltiy inside and out. 2 of 6 residents present and observed in common area during todays visit.

During visit LPA completed interviews, toured, requested and reviewed documentation (menus and physicians reports, pre-admission appraisals). LPA did not observe a sufficient amount of fresh fruits and vegetables or protein in the refrigerator/pantry for the 6 resdents in care. The allegation is SUBSTANTIATED. Deficiency cited on 9099D per Title 22. If not corrected, this poses a health, safety and or personal rights risk to residents in care.

A plan of correction was developed by Administrator, RoseMarie and reviewed by LPA. A copy of this report, deficiencies and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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-20250714101422
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: BONAVENTE HOME FOR THE ELDERLY #2
FACILITY NUMBER: 107207113
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/01/2025
Section Cited
CCR
87555(a)
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87555 General Food Service Requirements (a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council. All food shall be selected, stored, prepared and served in a safe and healthful manner.
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Administrator stated they will have a meeting with residents to generate a new menu. Once grogeries have been purchased itemized receipts and meeting notes will be sent to CCL by POC date as proof of correction.
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This requirement was not met as evidence by: LPA observation. The licensee did not comply with the section cited above in that the LPA did not observe a sufficient amount of fresh fruits and vegetables or protein in the refrigerator/pantry for the 6 resdents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2