107208987-5-5-2021-24-AS-SPIY-C2VL38-20210510082330

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 107208987
Report Date: 01/31/2021
Date Signed: 05/05/2021 08:40:43 AM

Unfounded

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
12/03/2020 and conducted by Evaluator Shawna Doucette

COMPLAINT CONTROL NUMBER: 24-AS-20201203110904

FACILITY NAME:	CHERRY AND MICHAEL'S HOME		FACILITY NUMBER:	107208987
ADMINISTRATOR:	ALACAR. CAROLINE		FACILITY TYPE:	740
ADDRESS:	4640 E. KAVILAND		TELEPHONE:	(559) 301-4720
CITY:	FRESNO	STATE: CA	ZIP CODE:	93725
CAPACITY:	4	CENSUS: 3	DATE:	01/31/2021
		UNANNOUNCED	TIME BEGAN:	04:34 PM
MET WITH:	Licensee Caroline Alacar		TIME COMPLETED:	06:30 PM

ALLEGATION(S):

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Facility staff are not arranging medical attention for a resident's needs
Facility staff will not call a resident's counselor
Facility staff do not answer their community telephone
Facility meals are not nutritious

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Shawna Doucette contacted the facility via telephone to commence a complaint investigation via telephone due to COVID-19 and pre-cautionary measures. LPA identified herself and discussed the purpose of the call and the elements of the allegations with Licensee Caroline Alacar.

LPA interviewed staff, witnesses and CVRC case worker. Licensee had a scheduled medical appointment for C1 on December 14, 2020, which was confirmed by CVRC Caseworker Jesenia Becerra, who advised the client was seen on that date. Due to the client being a new client with CVRC medical insurance and paperwork was still being processed. LPA requested the Licensee to submit a menu. Licensee advised the clients meals are set up by a nurtitionist. Licensee submitted a copy of the menu prepared by the nutritionist. LPA, CVRC and witness have had no issues getting a hold of staff when calling the community telephone. Licensee submitted C1's 602 and IPP.

An exit interview was conducted with Licensee Caroline Alacar via telephone and a copy of this report was provided to Licensee Caroline Alacar via email and an electronic email read receipt confirms receiving these documents. It was determined that the allegations: Facility staff are not arranging medical attention for a resident's needs, Facility staff will not call a resident's counselor, Facility staff do not answer their community and Facility meals are not nutritious telephone is UNFOUNDED.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2021

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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