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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209376
Report Date: 10/01/2024
Date Signed: 10/01/2024 12:32:11 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
07/16/2024 and conducted by Evaluator Alexandria Walton
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240716092733
FACILITY NAME:PATHWAY HOME CAREFACILITY NUMBER:
157209376
ADMINISTRATOR:JONHSON, JAIMYFACILITY TYPE:
740
ADDRESS:416 LANSING DRIVETELEPHONE:
(661) 972-6051
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:4CENSUS: 3DATE:
10/01/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator, Diana DiazTIME COMPLETED:
12:46 PM
ALLEGATION(S):
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9
Staff opened a resident's mail
Staff do not ensure that residents' dietary needs are met
Staff confines residents to their rooms
Staff do not ensure that the facility is free from odor
Staff do not ensure that the facility is maintained sanitary
Staff are not able to communicate with residents to meet their needs
INVESTIGATION FINDINGS:
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On 10/01/2024, Licensing Program Analyst (LPA) Walton arrived unannounced to deliver findings on the above allegations. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with House Manager, Diana Diaz.

During the investigation, LPA conducted interviews and reviewed records. Based on record review and interviews, the above allegations are UNSUBSTANTIATED. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

No deficiencies issued. Exit interview conducted. A copy of this report was discussed and provided to House Manager, Diana Diaz, whose signature on this form confirms receipt of this document.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
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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