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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209324
Report Date: 05/22/2025
Date Signed: 05/22/2025 07:56:23 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
03/12/2025 and conducted by Evaluator Martin Vega
COMPLAINT CONTROL NUMBER: 24-AS-20250312082833
FACILITY NAME:GROVE, THEFACILITY NUMBER:
107209324
ADMINISTRATOR:BREWER, NORSHELLFACILITY TYPE:
740
ADDRESS:7444 NORTH CEDAR AVETELEPHONE:
(801) 815-0808
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:130CENSUS: 83DATE:
05/22/2025
UNANNOUNCEDTIME BEGAN:
07:01 PM
MET WITH:Administrator - Norshell BrewerTIME COMPLETED:
08:30 PM
ALLEGATION(S):
1
2
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5
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7
8
9
Staff do not ensure medications are dispensed as prescribed
Staff due not ensure reporting requirements are being followed
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/22/2025, Licensing Program Analyst (LPA) M Vega arrived unannounced to conduct a complaint investigation. LPA introduced self, stated the purpose of the visit to Administrator - Norshell Brewer.

During the investigation, LPA conducted interviews and records reviews. Based on the information received, the allegations, Staff do not ensure medications are dispensed as prescribed and Staff do not ensure reporting requirements are being followed are Unfounded, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

Exit interview conducted. A copy of this report was discussed and provided to Administrator - Norshell Brewer whose signature on this form confirms receipt of this document.
No citations were issued at the time of this visit.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Martin Vega
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
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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