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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209480
Report Date: 10/27/2025
Date Signed: 10/27/2025 05:10:21 PM

Unsubstantiated


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
09/22/2025 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20250922144728
FACILITY NAME:STONEHAVEN SENIOR LIVINGFACILITY NUMBER:
107209480
ADMINISTRATOR:SALOW, DONALDFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(659) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 93DATE:
10/27/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Consultant Jay Cee Sanderson and Staff Radhika JewaTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Resident sustained a severe fracture due to staff neglect
Staff did not assist resident after a fall
Staff made inappropriate comments towards residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA)'s Shawna Doucette and Brianna Miranda conducted an unannounced complaint visit and was granted entry by Staff Radhika Jewa. LPA's explained the purpose of the visit. Staff Radhika Jewa contacted Consultant Jaycee Sanderson who responded to assist with the visit.

LPA's reviewed records. LPA's interviewed staff and residents.

Based on interviews and records review, it was undetermined if a resident sustained a severe fracture due to staff neglect.

Based on interviews, LPA's received conflicting statements regarding R2's fall. It is undetermined if staff did not assist resident after a fall.

Based on interviews, it is undetermined if staff made inappropriate comments towards residents.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
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-20250922144728
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: STONEHAVEN SENIOR LIVING
FACILITY NUMBER: 107209480
VISIT DATE: 10/27/2025
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

A copy of this report was provided and signed by Staff Radhika Jewa.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2