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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 167209143
Report Date: 10/17/2023
Date Signed: 10/18/2023 09:12:36 AM

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
08/31/2023 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230831152122
FACILITY NAME:SPARKS' RESIDENTIAL MEADOWBROOKFACILITY NUMBER:
167209143
ADMINISTRATOR:SPARKS, CEIARAFACILITY TYPE:
740
ADDRESS:983 S GREEN STREETTELEPHONE:
(559) 772-8385
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:6CENSUS: 5DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator, Ceiara SparksTIME COMPLETED:
11:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not treat residents with respect
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Darius Williams conducted a follow up visit to deliver findings. LPA met with Administrator Ceiara Sparks and discussed the purpose of the visit.

LPA Williams left voicemails on the Reporting Parties phone requesting a return call to clarify information, and no calls have been returned to the LPA.

LPA Williams conducted interviews.

In regards to the allegation, staff does not treat residents with respect, LPA interviewed three staff and they all reported not observing any other staff making disrespectful statements or treating any resident disrespectful. LPA attempted to interview R1 with no success.

*Continued on LIC 9099C*
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
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 4
Control Number 24-AS-20230831152122
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: SPARKS' RESIDENTIAL MEADOWBROOK
FACILITY NUMBER: 167209143
VISIT DATE: 10/17/2023
NARRATIVE
1
2
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5
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7
8
9
10
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16
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21
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32
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
08/31/2023 and conducted by Evaluator Darius Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230831152122

FACILITY NAME:SPARKS' RESIDENTIAL MEADOWBROOKFACILITY NUMBER:
167209143
ADMINISTRATOR:SPARKS, CEIARAFACILITY TYPE:
740
ADDRESS:983 S GREEN STREETTELEPHONE:
(559) 772-8385
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:6CENSUS: 5DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator, Ceiara SparksTIME COMPLETED:
11:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not get timely medical care for the resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Darius Williams conducted a follow up visit to deliver findings. LPA met with Administrator Ceiara Sparks and discussed the purpose of the visit.

LPA Williams left voicemails on the Reporting Parties phone requesting a return call to clarify information, and no calls have been returned to the LPA.

LPA Williams conducted interviews and record reviews.

In regards to the allegation, staff did not get timely medical care for the resident, Resident 1 (R1) was seen by a health professional and a follow up visit was scheduled with their primary care physician.

*Continued on LIC 9099C*
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 24-AS-20230831152122
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: SPARKS' RESIDENTIAL MEADOWBROOK
FACILITY NUMBER: 167209143
VISIT DATE: 10/17/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
This agency has investigated the complaint alleging staff did not get timely medical care for resident. We have found that the complaint was UNFOUNDED, which means it could not have happened, and/or is without a reasonable basis, therefore we have dismissed the complaint.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4