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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247206554
Report Date: 03/05/2025
Date Signed: 03/07/2025 09:17:49 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
02/25/2025 and conducted by Evaluator Vadim Gorban
COMPLAINT CONTROL NUMBER: 24-AS-20250225131354
FACILITY NAME:KAZLIN INFINITE CARE LLCFACILITY NUMBER:
247206554
ADMINISTRATOR:ERLINDA MAGLIBAFACILITY TYPE:
740
ADDRESS:3554 EL REDONDO DRIVETELEPHONE:
(209) 349-8457
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY:6CENSUS: 4DATE:
03/05/2025
UNANNOUNCEDTIME BEGAN:
09:42 AM
MET WITH:house manager Maria FloresTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Neglect/Lack of Care and/or Supervision resulting in violation of a resident's personal rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 03/05/2025, Licensing Program Analyst (LPA) V Gorban arrived unannounced to commence complaint investigation on the above allegation. LPA introduced self, stated the purpose of the visit and met with house manager Maria Flores, administrator was notified but was not able to attend the visit.

Allegation: Neglect/Lack of Care and/or Supervision resulting in violation of a resident's personal rights During the course of the investigation, records were received and reviewed, staff and residents interviews were conducted, and facility was toured. Residents and staff interviewed denied neglect, lack of care and supervision. Based on records review and interviews conducted, there was insufficient evidence to prove or disprove neglect , lack of care and supervision resulting in violation of a resident's personal rights. Therefore, preponderance of evidence standard has not been met, therefore, the above allegations are found to be UNSUBSTANTIATED.

Exit interview was conducted. A copy of this report was provided to house manager, whose signature on this form confirms receipt of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2025
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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