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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206641
Report Date: 02/05/2025
Date Signed: 02/05/2025 02:49:39 PM

Document Has Been Signed on 02/05/2025 02:49 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:FRESNO GUEST HOME #7FACILITY NUMBER:
107206641
ADMINISTRATOR/
DIRECTOR:
KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:2228 E. LOS ALTOS AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
02/05/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Teresa LongTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 02/05/2025, Licensing Program Analyst (LPA) Daiquiri Boyd arrived at the facility unannounced to
conduct a required annual visit. LPA was granted entry by staff and explain the purpose of the visit. Administrator Teresa Long (AD) arrived at the facility shortly after, to assist in the inspection.


The residence was set at 74 F temperature and free of passageway obstructions inside and outside. LPA observed six bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean, and furnishing was in good condition. Hot water temperature was measured at 109.4 degrees F.

Kitchen toured, supply of food observed, and food stored properly for perishable and nonperishable. Medication and knives are locked in a front entry way closet. Cleaning supplies were locked in the laundry room. Smoke detectors and carbon monoxide are dual detectors, they were checked and operating. Fire extinguishers were charged and was serviced on 08/05/2024. Emergency disaster drills are conducted quarterly, last drill completed on 12/01/2024. First Aid kit was observed and found to be fully stocked.

LPA reviewed 3 staff files and 3 client binders.

There was outdoor seating for the residents. Outdoor area was clean and free of obstruction.

An exit interview was conducted, and a copy of this report was provided to AD whose signature confirms receipt.


No deficiencies were cited on this day.
LPA requested the following updated forms faxed to CCLD by 01/20/2025: Administrative Organization (LIC309), Personnel Report (LIC 500), Proof of current Liability Coverage.
Sergiy PidgirnyTELEPHONE: (559) 243-8080
Daiquiri BoydTELEPHONE: 559-243-8080
DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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