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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208904
Report Date: 06/27/2023
Date Signed: 06/27/2023 03:33:14 PM

Document Has Been Signed on 06/27/2023 03:33 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:VICTORIA'S CARE HOMEFACILITY NUMBER:
107208904
ADMINISTRATOR:GITTI, JOSEPHFACILITY TYPE:
740
ADDRESS:5934 W LOCUST AVETELEPHONE:
(559) 960-3789
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY: 6CENSUS: 5DATE:
06/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:14 PM
MET WITH:Joseph GittiTIME COMPLETED:
04:00 PM
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
Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct Case Management-Incident. LPA met with and explained the purpose of the visit with Administrator (AD) Joseph Gitti.

On 6/15/23 the facility verbally reported an incident in which a resident (R1) stated that a staff member (S1) had spoken inappropriately in a sexual manner. Facility submitted a SOC341, Special Incident Report (SIR) as well as investigation documents and findings. S1 was removed from the facility when the allegation was made, an investigation was conducted and S1 has been permanently removed and no longer works at the facility.


There were no citations issued during this case management



An exit interview was conducted and a copy of this report was provided to Joseph Gitti whose signature confirms receipt.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1