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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157209425
Report Date: 12/22/2025
Date Signed: 12/22/2025 03:07:11 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
12/19/2025 and conducted by Evaluator Mai Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20251219150428
FACILITY NAME:AMERICAN SENIOR LIVINGFACILITY NUMBER:
157209425
ADMINISTRATOR:JUAREZ, LINA F DIAZFACILITY TYPE:
740
ADDRESS:9003 DROVERS RUN RDTELEPHONE:
(661) 493-8209
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:6CENSUS: 5DATE:
12/22/2025
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Licensee/Administrator Lina Juarez and Licensee Shervin MohammadiTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff spoke to resident in an inappropriate manner.
Staff did not assist resident for an extended period of time.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On this date 12/22/25, Licensing Program Analyst (LPA) M. Yang conducted initial complaint investigation. LPA introduce self, stated the purpose of the visit, and met with Licensee/Administrator (A1) Lina Juarez and Licensee (L1) Shervin Mohammadi arrived shortly. LPA discussed complaint and delivered complaint findings to Licensees.

During the course of the investigation, the Department conducted interviews and reviewed records. Staff and residents confirm staff did not speak to resident in an appropriate manner. Staff attended to resident needs when requested.

Based on interviews conducted, staff alleged spoke to the resident in an appropriate manner and did not assist resident for an extended period of time, the preponderance of evidence has not been met. Therefore, the above allegations are found to be UNSUBSTANTIATED. An exit interview was conducted. A copy of this report was provided to Licensee/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: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
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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