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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209205
Report Date: 10/01/2024
Date Signed: 10/01/2024 02:02:36 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
08/30/2024 and conducted by Evaluator Daiquiri Boyd
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240830104333
FACILITY NAME:FRESNO GUEST HOME #16FACILITY NUMBER:
107209205
ADMINISTRATOR:KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:6859 N. CHANCE AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 6DATE:
10/01/2024
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Teresa LongTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff speaks inappropriately to residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Daiquiri Boyd conducted an unannounced visit to the facility for the purspose of delivering the findings of this investigation into allegation: staff speaks inappropriately to residents in care. LPA met with Administrator Teresa Long and discussed the findings.
During the course of the investigation, LPA conducted interviews with residents and staff, as well as a file review of two residents files.
LPA found there to be differing statements made by staff and by residents in care. Due to inconsistent statements made, the Department has found the above allegation to be UNSUBSTANTIATED.
Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Daiquiri BoydTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
08/30/2024 and conducted by Evaluator Daiquiri Boyd
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20240830104333

FACILITY NAME:FRESNO GUEST HOME #16FACILITY NUMBER:
107209205
ADMINISTRATOR:KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:6859 N. CHANCE AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 6DATE:
10/01/2024
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Teresa LongTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not according residents privacy
Staff are interfering with resident visits
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Daiquiri Boyd conducted the complaint investigation visit to the facility and met with staff.
Administrator Teresa Long was informed of LPA presence by phone and then Administrator responded to the facility.
During the course of this investigation LPA reviewed facility files, interviewed residents and staff relevant to the complaint investigation. It was determined that the above allegations: Stafff are not according residents privacy and staff are interfering with resdient visits is UNFOUNDED.
This agency has investigated the complaint alleging the staff are not according residents privacy and staff are interfering with residents visits and we have found that the complaint was unfounded, therefore we have dismissed the complaint.
Unfounded
Estimated Days of Completion:
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 243-8080
LICENSING EVALUATOR NAME: Daiquiri BoydTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2