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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209048
Report Date: 09/24/2024
Date Signed: 09/24/2024 03:53:49 PM

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
09/16/2024 and conducted by Evaluator Katie Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240916165135
FACILITY NAME:RIVER BLUFFS MEMORY CARE COMMUNITYFACILITY NUMBER:
107209048
ADMINISTRATOR:HURLEY, DONNAFACILITY TYPE:
740
ADDRESS:5425 W. SPRUCE AVE.TELEPHONE:
(559) 840-9347
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:36CENSUS: 34DATE:
09/24/2024
UNANNOUNCEDTIME BEGAN:
02:13 PM
MET WITH:Alexis MartinTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yells at residents in care
Staff is racist towards a resident in care
Staff did not ensure residents clothing was changed
Staff changed a resident in an aggressive manner
Staff are not meeting the needs of a resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct the initial complaint investigation. LPA also delivered investigation findings during the visit.

This Department investigated the allegations listed above. LPA toured the facility and found residents dressed in clean clothes with no odors noticed. Bedding was found to be clean as well. Multiple Care Providers (CPs) and Med Techs (MTs) from both AM and PM shifts were interviewed. All staff members interviewed denied seeing or knowing about any of the allegations listed above occurring at the facility. Multiple resident interviews were attempted. The residents were unable to answer or participate in conversation due to Dementia. Record reviews were conducted and revealed that R1's ostomy and catheter bags are changed or drained daily and as needed by trained staff.

Based on interview and record review the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove that the alleged violations did or did not occur.

There were no citations issued. An exit interview was conducted and a copy of this report was left with Alexis Martin, whose signature confirms receipt of these documents.



Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024
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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