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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206929
Report Date: 08/25/2025
Date Signed: 08/25/2025 06:24:32 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/08/2025 and conducted by Evaluator Katie Brown
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20250408125753
FACILITY NAME:PAINTBRUSH ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
107206929
ADMINISTRATOR:EDWARDS, DEANNEFACILITY TYPE:
740
ADDRESS:4356 W ASHLAN AVETELEPHONE:
(559) 275-2000
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:110CENSUS: 70DATE:
08/25/2025
UNANNOUNCEDTIME BEGAN:
03:42 PM
MET WITH:Deanne EdwardsTIME COMPLETED:
03:43 PM
ALLEGATION(S):
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9
Resident sustained unexplained injuries while in care
Staff are not safeguarding resident's personal possessions while in care
Staff are not preventing a dog/dogs that is/are present in the facility from harming resident in care
INVESTIGATION FINDINGS:
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2
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Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct a subsequent complaint visit. LPA explained the reason for the visit and discussed the allegations with Administrator (AD) Deanne Edwards. Investigation findings were delivered to the facility during this visit.

This Department investigated the allegations above.

Resident R1 is under the care of Compassionate Care Hospice. Record Review of R1's facility file, Chart notes, Hospice notes and current Hospice Care Plan dated 2/6/25 was conducted. R1’s conditions, including changes in skin care needs wound care and treatments are properly documented. Facility Chart notes also record the ongoing communication between the facility staff, R1's Responsible Party and the Hospice Agency.

See LIC9099C for continuation of this report


Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 24-AS-20250408125753
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: PAINTBRUSH ASSISTED LIVING AND MEMORY CARE
FACILITY NUMBER: 107206929
VISIT DATE: 08/25/2025
NARRATIVE
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Continuation -

Staff are not safeguarding resident's personal possessions while in care
Staff are not preventing a dog/dogs that is/are present in the facility from harming resident in care

After further review of the statement submitted by the Reporting Party (RP) which generated this complaint, it is determined that the two (2) allegations above were not made in reference to incidents that occurred at the facility.

This Agency has investigated the allegations listed. We have found that the allegations are UNFOUNDED, therefore we have dismissed the allegations.

There were no citations issued

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2