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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206929
Report Date: 10/16/2024
Date Signed: 10/16/2024 01:42:47 PM


Document Has Been Signed on 10/16/2024 01:42 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:PAINTBRUSH ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
107206929
ADMINISTRATOR:JENNIFER VASQUEZFACILITY TYPE:
740
ADDRESS:4356 W ASHLAN AVETELEPHONE:
(559) 275-2000
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:110CENSUS: 67DATE:
10/16/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
09:18 AM
MET WITH:Melinda OcaranzaTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct a Case Management - Health & Safety Inspection. LPA met with and explained the reason for the visit with Resident Care Director (RCD) Melinda Ocaranza. Angel Navaro was authorized to sign this report.

LPA and RCD toured the facility which including firstf resident apartments in Assisted Living (AL) as well as Memory Care (MC). In AL, LPA selected multiple apartments to observe including all residents receiving Hospice Care. Apartments were clean with unobstructed walkways. Linens and paper products were observed with extra supply available. LPA observed Med Techs, Care Staff, Housekeeping, Maintenance and Concierge staff. The kitchen was clean, staff were preparing lunch. Cleaning supplies and knives were properly stored. Required food supply was observed and properly stored.

During the tour of AL, LPA observed residents sitting in common areas such as open sitting rooms, the dining room, and Bistro area. These common areas were clean, odor free with clear walkways. There are daily and monthly activity calendars posted. The Activity Director was present and preparing for the day. Medication and Housekeeping carts were found to be locked appropriately as were Med Rooms. There were multiple patios and sitting areas available outdoors. The grounds were well kept with unobstructed walkways.

MC area was toured. Delayed egress doors were in working order. LPA observed 20 residents in common areas participating in a program or sitting at dining room tables. Apartments were accessible and clean. Cleaning/disinfecting products were properly secured. Linens and paper products were observed with extra supply available. Common areas and walkways were clear throughout.

During this visit, LPA interviewed RCD and Memory Care Director (MCD). LPA was provided copies of staff schedules, as well as staff and resident rosters

There were no health and safety issues observed during this inspection. No citations issued. An exit interview was conducted and a copy of this report was left with Angel Navaro.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Katie BrownTELEPHONE: (559) 498-9964
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2024
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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