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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547209374
Report Date: 05/30/2025
Date Signed: 06/02/2025 09:10:48 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
03/12/2025 and conducted by Evaluator Lisa Salazar
COMPLAINT CONTROL NUMBER: 24-AS-20250312094236
FACILITY NAME:GRAND OAKS ASSISTED LIVINGFACILITY NUMBER:
547209374
ADMINISTRATOR:SHELLHAMER, DAVIDFACILITY TYPE:
740
ADDRESS:999 NORTH M STREETTELEPHONE:
(559) 684-1001
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:85CENSUS: 58DATE:
05/30/2025
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:David Shellhamer, Administrator TIME COMPLETED:
05:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff retained resident whose needs are beyond the scope of care of the facility
Staff did not treat residents with respect
Staff allowed family members to reside at the facility
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/30/25, Licensing Program Analyst (LPA) L. Salazar arrived to the facility unannounced to deliver findings on the above allegations. LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility. LPA met with Administrator, David Shellhamer to discuss the findings.

During the investigation, LPA interviewed Reporting Party and staff. LPA reviewed R1's records and observed R1 was a new admission on 03/11/25. R1 was discharged from the hospital on 03/11/25, placed on hospice and passed away on 03/13/25. Hospice care plan was observed on file. Interviews with staff and residents were conflicting in regard to residents not being treated with respect. Resident R2 was admitted to the Skilled Nursing Facility (next door) on 02/27/25 and discharged from Assisted Living on 03/30/25. R2's son stayed in the AL facility for 3 days during the period 03/09/25-03/12/25.

The Department has investigated the allegations. Although the allegations may have happened, there is not a preponderance of evidence to prove that the alleged violations occurred, therefore the allegations are Unsubstantiated. Exit interview conducted and copy of report was left with Administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
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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