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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 247209172
Report Date: 03/05/2026
Date Signed: 03/05/2026 06:49:08 PM

Substantiated


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
02/04/2026 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260204151458
FACILITY NAME:VALLEY SPRING MEMORY CAREFACILITY NUMBER:
247209172
ADMINISTRATOR:REYNAGA, ELIZABETHFACILITY TYPE:
740
ADDRESS:555 MILLER LANETELEPHONE:
(209) 710-4783
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:50CENSUS: 23DATE:
03/05/2026
UNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Administrator Elizabeth ReynagaTIME COMPLETED:
06:30 PM
ALLEGATION(S):
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Staff mishandled a resident's medication
INVESTIGATION FINDINGS:
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On March 5, 2026 Licensing Program Analyst (LPA) B. Miranda arrived at the facility unannounced to deliver finding for the allegations listed above. LPA met with Interim Executive Director Natalie Levario and Administrator Elizabeth Reynaga.

The Department has investigated the allegation of: Staff mishandled a resident's mediation. LPA conducted multiple interviews with staff, and third party. LPA was informed there was a lapse with medication due to the medical coverage changing. This cause a resident's blood pressure to be elevated and to be sent to the emergency room.
Based on the Departments interviews & records review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Exit interview was conducted and a copy of this report LIC809, LIC809D, and appeal rights were provided to Administrator Elizabeth Reynaga.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026
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 2
Control Number 24-AS-20260204151458
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: VALLEY SPRING MEMORY CARE
FACILITY NUMBER: 247209172
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/06/2026
Section Cited
CCR
87464(f)(4)
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87464 Basic Services
(f) Basic services shall at a minimum include:
(4) Personal assistance and care as needed by the resident and as indicated in the pre-admission appraisal, with those activities of daily living such as dressing, eating, bathing and assistance with taking prescribed medications, as specified in Section 87608, Postural Supports.
This requirement is not met as evidenced by:
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Based on observation, interview, and record, facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. Resident had a lapse in medication which caused the resident to go to the emergency room for high blood pressure.
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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: Brenda Chan
LICENSING EVALUATOR NAME: Brianna Miranda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2