<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107207121
Report Date: 10/03/2024
Date Signed: 10/03/2024 02:58:59 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
04/17/2024 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20240417091828
FACILITY NAME:NINA'S HOMEFACILITY NUMBER:
107207121
ADMINISTRATOR:RODRIGUEZ, LETICIAFACILITY TYPE:
740
ADDRESS:6540 N. BRIARWOODTELEPHONE:
(559) 253-3024
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 4DATE:
10/03/2024
UNANNOUNCEDTIME BEGAN:
12:13 PM
MET WITH:Administrator, Leticia RodriguezTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are unable to communicate with residents to ensure that their needs are met
Staff speak inappropriately to a resident(s)
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/02/2024 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced visit to deliver complaint findings. LPA met with Administrator, Leticia Rodriguez, explained reason for visit and was permitted entry into the facility. LPA completed a health and safety check on residents in care. LPA observed residents in common areas and in rooms.

During the investigation interviews were completed and documentation was reviewed. The following was found:
Allegation: Staff are unable to communicate with residents to ensure that their needs are met
During the investigation documentation was reviewed, interviews completed, and observations were made during visits. RP alleged staff only speak and read Spanish preventing them from communicating with residents and meet their needs. RP alleged staff are unable to read the residents' prescriptions and distribute their medications as prescribed. LPA’s interviews with staff showed staff were knowledgeable in needs and services to be provided to residents. This allegation is UNSUBSTANTIATED.
CONT...

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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-20240417091828
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: NINA'S HOME
FACILITY NUMBER: 107207121
VISIT DATE: 10/03/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
CONT...

Allegation: Staff speak inappropriately to a resident
LPA completed interviews with staff, RP and residents. LPA was unable to verify this allegation. The allegation is UNSUBSTANTIATED.

Although the allegations may or may not have occurred, the preponderance of evidence standard has not been met per Title 22. The allegations listed above are UNSUBSTANTIATED.

Exit interview completed with Administrator, Leticia. A copy of this report was provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2