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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547209374
Report Date: 01/26/2026
Date Signed: 01/26/2026 11:09:11 AM

Substantiated


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
11/05/2025 and conducted by Evaluator Shawna Doucette
COMPLAINT CONTROL NUMBER: 24-AS-20251105104638
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: 67DATE:
01/26/2026
UNANNOUNCEDTIME BEGAN:
10:07 AM
MET WITH:Assistant Administrator Alena LemaTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff are not abiding to the admission agreement
Staff do not provide adequate transportation services
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to deliver findings. LPA met with Assistant Administrator Alena Lema.

LPA interviewed staff and residents. LPA reviewed records.

Based on records review and interviews, facility is charging a $35 dollar additional internet/wifi fee to residents. Facility does not have a list of optional services that show fees listed in the admissions agreement.

Based on records review and interviews, the admissions agreement states Licensee will provide transportation to medical and dental appointments. Based on interviews, since on or about August 2025, facility is not assisting residents with transportation to doctor/dental appointments.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026
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 3
Control Number 24-AS-20251105104638
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: GRAND OAKS ASSISTED LIVING
FACILITY NUMBER: 547209374
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/26/2026
Section Cited
CCR
87507(g)(2)
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87507 Admission Agreements (g) Admission agreements shall specify the following:(2) Additional items and services which are available. This requirement was not met as evidenced by: Licensee does not have an optional
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Licensee agrees to include an optional services listing services and prices in admissions agreement by POC due date 02/26/26.
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services list showing fees for optional services in the admissions agreement which poses a potential health safety and or personal rights risk to residents in care.
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Type B
02/26/2026
Section Cited
CCR
87507(f)
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87507 Admission Agreements (f) The licensee shall comply with all applicable terms and conditions set forth in the admission agreement, including all modifications and attachments. This requirement was not met as evidenced by: Licensee did not plan,
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Licensee agrees to submit a written plan on how this regulation will be met by POC due date 02/26/26.
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arrange and/or provide for transportation to medical and dental appointments which poses a potential health safety and or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20251105104638
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: GRAND OAKS ASSISTED LIVING
FACILITY NUMBER: 547209374
VISIT DATE: 01/26/2026
NARRATIVE
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Based on the interviews and records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6, Article 8, is being cited on the attached LIC 9099D.


A copy of this report with appeal rights and plan of correction was provided.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3