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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 355201055
Report Date: 04/16/2026
Date Signed: 04/17/2026 08:32:15 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
04/13/2026 and conducted by Evaluator Vadim Gorban
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260413161712
FACILITY NAME:WHISPERING PINES INN, LLCFACILITY NUMBER:
355201055
ADMINISTRATOR:PARK,CHARLES & MAEFACILITY TYPE:
740
ADDRESS:476 LOS VIBORAS ROADTELEPHONE:
(831) 636-9620
CITY:HOLLISTERSTATE: CAZIP CODE:
95023
CAPACITY:36CENSUS: 14DATE:
04/16/2026
UNANNOUNCEDTIME BEGAN:
02:09 PM
MET WITH:Administrator Charles ParkTIME COMPLETED:
05:30 PM
ALLEGATION(S):
1
2
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9
Staff are mismanaging resident's medication.
Staff are mismanaging residents' records
Facility is not sufficiently staff to meet the needs of the residents in care.
Staff did not follow infection control requirements.
INVESTIGATION FINDINGS:
1
2
3
4
5
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8
9
10
11
12
13
On 04/16/2026 Licensing Program Analyst (LPA) Gorban unannounced visited the facility to commence complaint investigation. LPA introduced self and met by Administrator; LPA stated purpose of the visit and was allowed entry.
During the complaint investigation LPA toured the facility conducting health and safety checks, reviewed records, and interviews.
Allegations: Based on interviews and records reviews, medications documented after each administration. Medication records appear up to date. Regarding residents' records, files updated with recent medical assessments and needs and services files are up to date. Regarding staffing, facility has substantial amount of staff to provide care and supervision. Regarding infection control, LPA reviewed facility infection control binder and interviewed administrator regarding infection control practice. Although the allegation may have happened or are valid, there are not a preponderance of evidence to prove the alleged violations did occur, therefore the allegations are Unsubstantiated.
Exit interview conducted, report signed and copy of this report provided for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Vadim Gorban
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2026
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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