<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 547203298
Report Date: 10/30/2025
Date Signed: 06/02/2026 02:17:53 PM

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
08/29/2025 and conducted by Evaluator Les Xiong
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250829085950
FACILITY NAME:AUTUMN OAKSFACILITY NUMBER:
547203298
ADMINISTRATOR:ONG, ANTONIO G.FACILITY TYPE:
740
ADDRESS:848 N. JAYE STREETTELEPHONE:
(559) 784-4144
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:44CENSUS: 2DATE:
10/30/2025
UNANNOUNCEDTIME BEGAN:
12:59 PM
MET WITH:LIsa OngTIME COMPLETED:
02:41 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
“This report is being amended to update the reporting manager.”

Staff did not provide nutritious meals to residents in care
Staff did not store perishable foods in covered containers
Staff retained expired foods at the facility for residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) L. Xiong conducted the complaint investigation to the facility. During the course of this investigation, LPA reviewed facility files relevant to the complaint and conducted a facility tour.
It was determined that the above allegations: Staff did not provide nutritious meals to residents in care, Staff did not store perishable foods in covered containers, and Staff retained expired foods at the facility for residents in care are SUBSTANTIATED.
The evidence from the investigation indicated that the facility is not practicing proper storing of food. Facility did not have food labeled and dated, they were not utilizing proper freezer storage and were storing food in broken and dirty refrigerators. Facility was not following a menu and would cook meals that were “going to expire”. It was observed that residents received a hamburger and cauliflower for lunch. The hamburger did not include any condiments or toppings. The facility received food from a local food bank that were close to the best buy date and did not prepare the meals prior to the best buy date.
The deficiencies for this complaint were issued during a case management visit conducted on 10/23/2025. Licensee has submitted a closure plan for the facility.
Exit interview conducted. A copy of this report was discussed and provided to Licensee, whose signature on this form confirms receipt of this document.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2025
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 1