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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157208940
Report Date: 02/06/2025
Date Signed: 02/06/2025 02:54:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
02/04/2025 and conducted by Evaluator Mai Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250204104020
FACILITY NAME:MAGNOLIA PLACEFACILITY NUMBER:
157208940
ADMINISTRATOR:ANDERSON, PAULFACILITY TYPE:
740
ADDRESS:8100 WESTWOLD DRIVETELEPHONE:
(661) 663-8400
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:146CENSUS: 116DATE:
02/06/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Paul Anderson and Director of Residential Services Shellie WhitlockTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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9
Licensee is not adequately addressing bed bug infestation at the facility.
Licensee is not ensuring that resident is provided with a safe environment while in care.
INVESTIGATION FINDINGS:
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2
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9
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On 02/06/25, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct initial complaint investigation. LPA introduced self, stated the purpose of the visit, and met with Administrator Paul Anderson and Director of Residential Services Shellie Whitlock.

During the course of the investigation, LPA conducted interviews, received copies of records, and toured the facility in memory care unit. Based on interviews conducted and records reviewed, the facility immediately treated the bed bugs found in resident’s room and scheduled pest control service to treat bed bugs. There was insufficient evidence to prove or disprove that resident is not provided with a safe environment while in care. Therefore, the preponderance of evidence standard has not been met, the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to the Administrator, whose signature on this form confirms receipt of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2025
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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