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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 07:45:40 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
02/17/2026 and conducted by Evaluator Brianna Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20260217132737
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: DATE:
03/05/2026
UNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Administrator Elizabeth ReynagaTIME COMPLETED:
08:30 PM
ALLEGATION(S):
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Staff did not post required signs in the facility
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 did not post required signs in the facility. LPA observed no signs posted for oxygen in use during initial visit on 2/18/2026. LPA conducted multiple interviews. During the interviews it was stated there were never any signs up indicating there was oxygen in use.
Based on the Departments interviews & 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 11, is being cited on the attached LIC 9099D.

Exit interview was conducted and a copy of this report LIC9099, LIC9099D, and appeal rights were provided to Interim Executive Director Natalie Levario.
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-20260217132737
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 B
03/12/2026
Section Cited
CCR
87618(b)(3)(B)
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87618 Oxygen Administration - Gas and Liquid
(b) In addition to Section 87611(b), the licensee shall be responsible for the following:
(3) Ensuring that the use of oxygen equipment meets the following requirements:
(B) "No Smoking-Oxygen in Use" signs shall be posted in the appropriate areas.
This requirement is not met as evidenced by:
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Licensee will sent a statement regarding procedure for posting signs of oxygen in use. Verifications will be sent to the Dept by POC due date.
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Based on observation, interview, and record, the facility did not comply with the regulation listed above, which poses a potential health and safety risk to residents in care. LPA conducted multiple interviews which stated there were not signs regarding oxygen in use.
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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