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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 100400070
Report Date: 03/04/2025
Date Signed: 03/04/2025 05:32:32 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/04/2025 05:32 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 HOMEFACILITY NUMBER:
100400070
ADMINISTRATOR/
DIRECTOR:		PAUL ROCHAFACILITY TYPE:
741
ADDRESS:6720 E KINGS CANYON RDTELEPHONE:
(559) 251-8414
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 392CENSUS: 233DATE:
03/04/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Paul RochaTIME VISIT/
INSPECTION COMPLETED:
04:36 PM
NARRATIVE
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On 3/04/25, Licensing Program Analysts (LPAs) M. Medina and D. Boyd. conducted an unannounced annual required inspection. LPAs stated the purpose of the visit and were allowed entry into the facility. LPAs met with Administrator, Paul Rocha, who conducted the tour of the facility with LPAs.

LPA Medina reviewed a sample of staff and resident files and observed the files to have the required documentation and staff training.

LPA Boyd will document the physical plant tour and inspection tool results on a separate report.

Exit interview conducted. No deficiencies cited.
SUPERVISORS NAME: Alexandria Walton
LICENSING EVALUATOR NAME: Melinda Medina
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
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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