100400070-3-4-2025-24-AS-DBOD-DEG3UX-20250304173415

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 100400070
Report Date: 03/04/2025
Date Signed: 03/04/2025 05:34:23 PM

Document Has Been Signed on 03/04/2025 05:34 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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
ADMINISTRATOR/ DIRECTOR:	PAUL ROCHA		FACILITY TYPE:	741
ADDRESS:	6720 E KINGS CANYON RD		TELEPHONE:	(559) 251-8414
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY: 392	TOTAL ENROLLED CHILDREN: 0	CENSUS: 233	DATE:	03/04/2025
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:35 AM
MET WITH:	Paul Rocha		TIME VISIT/ INSPECTION COMPLETED:	04:35 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPA) Daiquiri Boyd and Melinda Medina, conducted an unannounced annual visit to the facility and met with Administrator, Paul Rocha (AD). LPA stated the purpose of the visit and was accompanied by AD while conducting the inspection of the facility grounds. This facility includes several buildings. The main building is a three story building that houses residents that are Independent Living on floors one and three and Assisted Living on the second floor. Each floor has a choice of dining facilities and menu options. Menus are provided on site and by the interactive video/TV monitors in each wing of the facility. Kitchen toured and observed to be clean and well taken care of. Refrigerator was at 37 degrees F and freezers were at 0 degrees F. There was observed to be a perishable and non-perishable food supply to feed all residents for seven days. Independent Living consists of 70 residents and Assisted Living has 55 residents. LPA observed thermostat to be at 73 degrees F. On each level of the facility main building, there is a locked Maintenance room with cleaning supplies. There is a Medication Room on the second floor that is a locked room containing movable, locked medication carts. This facility uses PointClickCare system to track the medications the residents are taking. LPAs checked water temperatures in five resident bathrooms and found it to range from 115 degrees F to 120 degrees F. LPA observed laundry rooms with keyed entry to have working washers, dryers, and cleaning supplies. Each hallway in the facility contains a video monitor that displays the menu for the day, weather, activity times for all events taking place in the facility. LPAs inspected resident bedrooms for water temperature, non-slip surfaces, lighting, grab bars, seating. Residents receive housekeeping in Assisted Living daily and Independent Living receive housekeeping twice weekly. All rooms were found to be in like new condition, properly functioning, and well maintained. The Cognitive Care building (previously Memory Care) currently houses 34 residents. This building has it's own kitchen and three dining areas. Meals prepared here are specific to this building and are prepared to enhance well being of those with cognitive issues. There are currently eight residents on hospice care.

Sergiy Pidgirny	TELEPHONE: (559) 243-8080
Daiquiri Boyd	TELEPHONE: 559-243-8080
	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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
	VISIT DATE: 03/04/2025

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There are Independent Living Villas on the property of the facility and there are forty residents residing independently therein. LPAs toured one of the private, resident villas and found it to be newly built with new amenities and furnishings.

PPE for the whole community is centrally stored in all buildings for all residents. Last fire drill with staff was conducted on 12/25/24. Fire Department inspected interior sprinkler system on 12/18/24. The semi-annual alarm inspection was done by Fresno Fire Department. on 06/18/2024. LPAs observed and reviewed Infection Control Plan and Disaster Binders, both found to be updated.

LPA Medina reviewed staff and resident records and will document on a Annual Continuation report.

Exit interview conducted. A copy of this report provided for facility records.

No deficiencies cited during inspection.

SUPERVISOR'S NAME: Sergiy Pidgirny	TELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Daiquiri Boyd	TELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2025

LIC809 (FAS) - (06/04)

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