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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206819
Report Date: 06/06/2022
Date Signed: 06/08/2022 11:41:49 AM


Document Has Been Signed on 06/08/2022 11:41 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 06/08/2022 08:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

NARRATIVE
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This is an amended report.

On 06/06/2022, Licensing Program Analyst (LPA) Walton arrived unannounced at the above facility to conduct a case management – deficiencies inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Keghouhy Handian.

Upon review of facility file on 06/03/2022, the annual licensing fees for the above facility are overdue in the amount of $2,721.00. Fees were due on 09/29/2021. During a meeting held on 07/22/2021, Licensee and Administrator were informed of the overdue licensing fees and agreed to pay the overdue balance in full by 08/06/2021.

A deficiency is being cited in accordance with the California Code of Regulations, Title 22, Division 6, see attached 809D.

A non-compliance meeting has been scheduled for 06/23/2022 at 2:00PM. A letter with this information has been mailed via certified mail to the Licensee, as the Licensee's attendance at this meeting is required.

An exit interview was conducted, and a Plan of Correction was reviewed and developed with Administrator. A copy of this report and appeal rights were discussed and provided to Administrator, Keghouhy Handian whose signature on this form confirms receipt of this document.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:
DATE: 06/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2022
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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Document Has Been Signed on 06/08/2022 11:42 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 06/08/2022 08:54 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710


FACILITY NAME: CARING HOMES 2
FACILITY NUMBER: 107206819

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/17/2022
Section Cited

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(a) An applicant or licensee shall be charged fees as specified in Health and Safety Code section 1569.185.(a)… After initial licensure, a fee shall be charged by the department annually on each anniversary of the effective date of the license. This requirement was not met as evidenced by:
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Based on record review, the licensee did not ensure the above regulation was met as evidenced by the facility licensing fees being past due in the amount of $2,721.00. The balance was due on 09/29/2021.
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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: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Alexandria WaltonTELEPHONE: (559) 246-0128
LICENSING EVALUATOR SIGNATURE:
DATE: 06/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2022
LIC809 (FAS) - (06/04)
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