157209316-1-29-2026-24-AS-AWAN-DRTV9J-20260303151426

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 157209316
Report Date: 01/28/2026
Date Signed: 01/29/2026 04:55:30 PM

Substantiated

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
01/22/2026 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20260122170820

FACILITY NAME:	TRINITY, THE		FACILITY NUMBER:	157209316
ADMINISTRATOR:	LAZAGA, JETHRONEL		FACILITY TYPE:	740
ADDRESS:	200 TRINITY AVE		TELEPHONE:	(661) 563-1761
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY:	10	CENSUS: 5	DATE:	01/28/2026
		UNANNOUNCED	TIME BEGAN:	01:13 PM
MET WITH:	Jethronel Lazaga		TIME COMPLETED:	05:14 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff use inappropriate restraints on residents.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) L. Xiong conducted the an unannounced complaint investigation visit to the facility. LPA met with administrator J. Lazaga during the visit.
During the course of this complaint investigation LPA interviewed staff on duty and obtained and/or reviewed facility records. It was determined based on the interviews and records review that the above allegation is SUBSTANTIATED. The evidence from the investigation indicated that the facility staff did use inappropriate restraint on resident. Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.”)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026

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 3

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
01/22/2026 and conducted by Evaluator Les Xiong

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20260122170820

FACILITY NAME:	TRINITY, THE		FACILITY NUMBER:	157209316
ADMINISTRATOR:	LAZAGA, JETHRONEL		FACILITY TYPE:	740
ADDRESS:	200 TRINITY AVE		TELEPHONE:	(661) 563-1761
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY:	10	CENSUS: 5	DATE:	01/28/2026
		UNANNOUNCED	TIME BEGAN:	01:13 PM
MET WITH:	Jethronel Lazaga		TIME COMPLETED:	05:14 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff leave residents in soiled diapers for extended periods of time.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) L. Xiong conducted the complaint investigation visit to the facility. During this visit LPA delivered investigation findings regarding the above allegations.The Department has investigated the complaint alleging: Staff leave residents in soiled diapers for extended periods of time. Based on the interviews conducted and/or records review the above allegation is UNSUBSTANTIATED. 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 24-AS-20260122170820

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: TRINITY, THE	FACILITY NUMBER: 157209316
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/12/2026 Section Cited CCR 97608(a)(3)	1 2 3 4 5 6 7	87608(a)(3) Postural Supports (a) Based on the individual's preadmission appraisal, and subsequent changes to that appraisal, the facility shall provide assistance and care for the resident in those activities of daily living which the resident is unable to do for himself/herself. Postural supports may be used under the following conditions. (3) A written order from a physician indicating the need for the postural support shall be maintained in the resident’s record. The licensing agency shall be authorized to require other additional documentation if needed to verify the order.	1 2 3 4 5 6 7	Per Administrator, will conduct an inservice-training for staff by the poc date.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3