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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209480
Report Date: 06/27/2026
Date Signed: 06/27/2026 12:15:36 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
01/06/2026 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20260106091029
FACILITY NAME:STONEHAVEN SENIOR LIVINGFACILITY NUMBER:
107209480
ADMINISTRATOR:SALOW, DONALDFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(659) 251-8417
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:116CENSUS: 105DATE:
06/27/2026
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Administrator, Radhika "Rads" JawaTIME COMPLETED:
12:22 PM
ALLEGATION(S):
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Staff did not respond to resident's call button in a timely manner
INVESTIGATION FINDINGS:
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On 06/27/2026 Licensing Program Analyst (LPA) M. Garza completed an unannounced complaint visit to deliver findings. LPA was unable to locate staff and went to Skilled Nursing Facility for assistance in getting in contact with Administrator. LPA spoke with several staff (kitchen, caregivers and RN) who were unaware of who to contact. Housekeeping Director, Percilla Mendez was found and contacted Administrator, Radhika "Rads" Jawa. Reason for visit was explained to Administrator and Administrator arrived an hour and 15 minutes later.

During the complaint investigation interviews were conducted and documentation was requested and reviewed. During interviews with residents, 6 of 6 residents confirmed that when a call button is pushed it takes a significate amount of time for staff to answer the call lights, "if they come at all". The allegation listed above is SUBSTANTIATED. The preponderance of evidence standard has been met per California Code of Regulations, meaning the allegation occurred or has occurred. Deficiencies cited per Title 22 on attached 9099D.

Exit interview completed with Administrator, Rads. A plan of correction was provided by Administrator and reviewed by LPA. A copy of this report, deficiency and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2026
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
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
01/06/2026 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20260106091029

FACILITY NAME:STONEHAVEN SENIOR LIVINGFACILITY NUMBER:
107209480
ADMINISTRATOR:SALOW, DONALDFACILITY TYPE:
740
ADDRESS:1717 SOUTH WINERY AVENUETELEPHONE:
(659) 251-8417
CITY:FRESNOSTATE:CAZIP CODE:
93727
CAPACITY:116CENSUS: 105DATE:
06/27/2026
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Administrator, Radhika "Rads" JawaTIME COMPLETED:
12:22 PM
ALLEGATION(S):
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2
3
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9
Staff did not distribute resident's medication as prescribed
Staff did not assist resident with obtaining medical care
Staff did not ensure that resident was hydrated
INVESTIGATION FINDINGS:
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On 06/27/2026 Licensing Program Analyst (LPA) M. Garza completed an unannounced complaint visit to deliver findings. LPA was unable to locate staff and went to Skilled Nursing Facility for assistance in getting in contact with Administrator. LPA spoke with several staff (kitchen, caregivers and RN) who were unaware of who to contact. Housekeeping Director, Percilla Mendez was found and contacted Administrator, Radhika "Rads" Jawa. Reason for visit was explained to Administrator and Administrator arrived an hour and 15 minutes later.

During complaint investigation LPA completed interviews and reviewed documentation. The complaint allegations have been investigated and have been found to be UNSUBSTANTIATED. Although the allegations may or may not have occurred the preponderance of evidence standard per California Code of Regulations, Title 22 were unable to be met. No deficiencies cited during today’s visit.

Exit interview completed. A copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20260106091029
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: STONEHAVEN SENIOR LIVING
FACILITY NUMBER: 107209480
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/07/2026
Section Cited
CCR
87411(a)
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87411 Personnel Requirements – General (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.
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All staff meeting and training will be conducted. In service sign in sheets and training material for assiting residents in a timely manner will be provided to CCL by POC date as proof of correction.
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This requirement was not met as evidence by LPA interviews conducted. The licnesee did not comply with the section cited above in that 6 of 6 residents interviewed disclosed staff are not answering call lights in a timely manner, when residents need assistance, “if they come at all”. This 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.
SUPERVISOR'S NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3