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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209397
Report Date: 05/13/2024
Date Signed: 05/13/2024 11:18:36 AM

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
05/09/2024 and conducted by Evaluator Mai Yang
COMPLAINT CONTROL NUMBER: 24-AS-20240509161036
FACILITY NAME:ALONDRA HOMEFACILITY NUMBER:
157209397
ADMINISTRATOR:LAZAGA, CECILIA& JETHRONELFACILITY TYPE:
740
ADDRESS:9817 ALONDRA DRTELEPHONE:
(661) 563-0683
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:6CENSUS: 4DATE:
05/13/2024
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Jethronel Lazage, LicenseeTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Uncleared staff providing care to residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/13/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an initial complaint inspection. LPA introduce self, stated the purpose of the visit, and met with Licensee 1 (L1) Jethronel Lazage. Licensee 2 (L2) Cecilia Lazaga arrived shortly.

LPA conducted interviews and received copies of records. Facility is licensed as of March 2024. S1 and S2 was at the facility prior to facility being licensed. All staff working at the facility are associated and fingerprinted cleared.

Based on LPA record reviewed and interviews which were conducted, the allegation of uncleared staff providing care to residents, the preponderance of evidence standard has not been met, therefore the allegation is found to be UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided to the L1, whose signature confirms received of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024
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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