100400070-5-29-2024-24-AS-SPIY-D49KSV-20240412081009

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 100400070
Report Date: 03/18/2024
Date Signed: 05/29/2024 11:29:58 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
10/27/2023 and conducted by Evaluator Lissett Padgett

PUBLIC

COMPLAINT CONTROL NUMBER: 24-AS-20231027143209

FACILITY NAME:	CALIFORNIA ARMENIAN HOME		FACILITY NUMBER:	100400070
ADMINISTRATOR:	PAUL ROCHA		FACILITY TYPE:	741
ADDRESS:	6720 E KINGS CANYON RD		TELEPHONE:	(559) 251-8414
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	392	CENSUS: 234	DATE:	03/18/2024
		UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Paul Rocha, Administrator		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff do not prevent inappropriate interactions between residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst L. Padgett arrived unannounced to deliver amended investigative findings on the above allegation. LPA met with Paul Rocha and explained the purpose of the visit.

The Department investigated the complaint alleging: Staff do not prevent inappropriate interactions between residents. During the course of the investigation the Department conducted interviews with staff and witnesses and reviewed resident and facility records, including incident reports, resident care notes, physician’s report pertaining to Residents R1 and R2.

The Department determined that staff on duty did not prevent sexually inappropriate non-consensual interactions between the two residents in the Memory Care Unit.

Per Department’s investigation: On 10/24/2023, in the Memory Care Unit of the facility resident R1 was found in resident R2’s bedroom; resident R2 had his arm around resident R1’s waist and resident R1 was pushing resident R2 away. Resident R2’s genitalia was exposed out of his brief.

On 10/27/2023 in the Memory Care Unit of the facility staff S1 went to check on resident R2 in his bedroom and saw resident R2 sitting on his bed with resident R1 laying across Resident R2’s body. Resident R1’s pants were down to her ankles, briefs pushed to the side and R2’s fingers were inserted in R1’s genitalia. Staff S1 pulled resident R1 away and assisted resident R1 to her bedroom.
Staff S1 also advised Memory Care Director (S2), but Staff S2 stated the residents had personal rights to be involved in romantic/physical relationships.

Based on resident R1’s Admission Agreement, resident R1 has a power of attorney assigned and is unable to make decisions or give consent.

During the Department’s interviews with Executive Director (S3) and Memory Care Director (S2); they reported these two incidents were isolated and there were no prior or subsequent incidents. However, per resident R2’s Progress Notes, there were two incidents where resident R2 was seen touching/caressing other residents in the facility.

Additionally, there were two other incidents that were not documented: resident R2 had resident R1 in resident R2’s bedroom, and resident R1 was crying, and resident R2 attempted to touch another resident’s breast area.

Based on the investigation conducted by the Department, the preponderance of evidence standard has been met, therefore the allegation, Staff do not prevent inappropriate interactions between residents is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 6, Chapter 8) are being cited on the attached LIC 9099-D.
Exit interview was conducted with Paul Rocha and appeal rights were provided.

Substantiated

Estimated Days of Completion: 0

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Lissett Padgett	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 24-AS-20231027143209

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: CALIFORNIA ARMENIAN HOME	FACILITY NUMBER: 100400070
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/18/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type A 03/22/2024 Section Cited CCR 87468.2(a)(8)	1 2 3 4 5 6 7	87468.2(a)(8) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, ... for the elderly shall have all of the following personal rights: (8) To be free from neglect… intimidation, and verbal, mental, physical, or sexual abuse.	1 2 3 4 5 6 7	Plan of Correction (POC); in service training conducted with staff on Mandating Reporting/Residents Rights was submitted by Licensee by as requested.No further action is required.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on the investigation by the Department, staff in the Memory Care Unit did not prevent resident (R1) from being inappropriately touched by R2. This posed an immediate risk to the health, safety and/or personal rights of the residents in care.	8 9 10 11 12 13 14
Deficiency Dismissed Type B 03/25/2024 Section Cited CCR 87211(a)(1)(D)	1 2 3 4 5 6 7	This deficiency was dismissed due to granted appeal	1 2 3 4 5 6 7
	8 9 10 11 12 13 14		8 9 10 11 12 13 14

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: Brenda White	TELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Sergiy Pidgirny	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC9099 (FAS) - (06/04)

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