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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209444
Report Date: 11/05/2025
Date Signed: 11/05/2025 07:13:32 PM

Document Has Been Signed on 11/05/2025 07:13 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:HELPING HANDS SENIOR CAREFACILITY NUMBER:
107209444
ADMINISTRATOR/
DIRECTOR:		NGUYEN, ELSAFACILITY TYPE:
740
ADDRESS:825 S WILLOW AVENUETELEPHONE:
(650) 776-2280
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 30CENSUS: 9DATE:
11/05/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:02 PM
MET WITH:Jessica YglesiasTIME VISIT/
INSPECTION COMPLETED:
07:30 PM
NARRATIVE
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On 11/05/2025, Licensing Program Analysts (LPAs) M. Medina and L. Salazar arrived to conduct Case Management visit. LPA's arrived, stated purpose of visit and met with Administrator Assistant, Jessica Yglesias to conduct visit. Administrator, Elsa Nguyen was contacted by telephone to advise of visit and was unavailable to be present.

This case management visit is being conducted to cite deficiencies observed during visits conducted on 10/14/25 and 10/30/25 and during complaint visit on 11/05/25. During previous visits, LPAs toured facility, reviewed records, conducted interviews, and observed residents.

LPAs interviews with R7 and S3 state Home Health changed R7’s catheter wrong, facility was unable to provide proof of home health care plan. LPAs observation and interviews with R7 and S3, stating S3 performs the glucose testing for R7 and prepares the dose of insulin. LPA observed S3 conducting glucose testing, insulin dial and R7 injecting themselves with insulin pen.

During interview with Administrator and review of facility's program description (plan of operation), there is no proof of scheduled toileting at regular intervals. During record review, LPA observed there was no reappraisal in R2's file. LPAs request of training records for 5 out of 10 restricted health conditions observed involving R2 for oxygen and wound care, R4 for managed incontinence and R7 for catheter and diabetic care. LPAs records review and observation of R2, R2 was hospitalized for 3 days to receive antibiotics for a serious wound on their leg.
NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Melinda Medina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 9
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 03:05 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
CCR
87631(a)(1)

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87631 Healing Wounds
(a) Except as specified in Section 87611(a), the licensee shall be permitted to accept or retain a resident who has a healing wound under the following circumstances: (1) When care is performed by or under the supervision of an appropriately skilled professional.
This requirement was not met as evidenced by LPAs request for Home Health records and interviews with staff, there is no plan of care.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Type A
11/06/2025
Section Cited
CCR
87466

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87466 Observation of the Resident
The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any. **This requirement is not met as evidenced by LPAs review of R2 hospital records stating R2 was sent to the ER via ambulance by the wound specialist clinic due to worsening of the right leg wound.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation


An immediate Civil penalty in the amount of $500 is hereby assessed.
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R2 was hospitalized for 3 days to receive antibiotics for a serious infection on their leg. An immediate civil penalty in the amount of $500 is hereby assessed. If not corrected, the violation will have a direct and immediate risk to the health, safety, or personal rights of clients in care.
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Type A
11/06/2025
Section Cited
CCR
87623(b)(2)

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87623 Indwelling Urinary Catheter
(b) In addition to Section 87611, General Requirements for Allowable Health Conditions, the licensee shall be responsible for the following:(2) Ensuring that the bag and tubing are changed by an appropriately skilled professional should the resident require assistance. (A) The bag may be emptied by facility staff who receive instruction from an appropriately skilled professional. **This requirement was not met as evidenced by LPAs interview with R7 and records review of R7s file.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
Page: 3 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 03:24 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
CCR
87628(a)

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87628 Diabetes
(a) The licensee shall be permitted to accept or retain a resident who has diabetes if the resident is able to perform his/her own glucose testing with blood or urine specimens, and is able to administer his/her own medication including medication administered orally or through injection, or has it administered by an appropriately skilled professional. **This requirement was not met as evidenced by LPAs observation and interviews with R7 and S3 stating S3 performs the glucose testing for R7 and prepares the dose of insulin. LPA observed S3 conducting glucose testing, insulin dial and R7 injecting themselves with insulin pen.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Type A
11/06/2025
Section Cited
CCR
87609(b)(4)(A)

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87609 Allowable Health Conditions and the Use of Home Health Agencies
(b) Incidental medical care may be provided to residents through a licensed home health agency provided the following conditions are met: (4) The licensee and home health agency agree in writing on the responsibilities of the home health agency, and those of the licensee in caring for the resident’s medical condition(s). (A) The written agreement shall reflect the services, frequency and duration of care.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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**This requirement was not met as evidenced by LPAs interviews with R7 and S3, stating Home Health changed R7’s catheter wrong. Facility was unable to provide proof of home health care plan.
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Type A
11/06/2025
Section Cited
CCR
87613(a)(2)

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87613 General Requirements for Restricted Health Conditions
(a) Prior to admission of a resident with a restricted health condition, the licensee shall: (2) Ensure that facility staff who will participate in meeting the resident’s specialized care needs complete training provided by a licensed professional sufficient to meet those needs. **This requirement was not met as evidenced by LPAs request of training records for 5 out of 10 restricted health conditions observed involving R2 for oxygen and wound care, R4 for managed incontinence and R7 for catheter and diabetic care.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
Page: 4 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 03:33 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
CCR
87463(e)

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87463 Reappraisals
(e) The licensee shall immediately, or as soon as reasonably possible, bring any significant change in condition, as defined in Section 87101, Definitions, to the attention of the appropriate licensed medical professional and if applicable, other specialized care provider. Documentation of such communication shall be added to the resident's record and shall include:
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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**This requirement was not met as evidenced by LPA review of R2's records. There was no reappraisal observed in R2s file.
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Type A
11/06/2025
Section Cited
CCR87633(b)(4)

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87633 Hospice Care of Terminally Ill Residents
(b) A current and complete hospice care plan shall be maintained in the facility for each hospice resident and include the following:(4) A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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**This requirement was not met as evidenced by LPAs records review and interviews conducted, there is was no hospice care plan or descrption of resposibilty for R4's care.
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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.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
Page: 5 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444
VISIT DATE: 11/05/2025
NARRATIVE
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(Continued from LIC 809)

LPAs records review and interviews conducted, there is was no hospice care plan or description of responsibility for R4's care.

During interview with residents R3, R4, and administrator there was an incident involving law enforcement on site searching for a suspect, the suspect had entered and was hiding in R6's home.

LPAs have conducted 3 facility visits on 10/14/25, 10/30/25 & 11/05/25. Interviews with residents state they may see Administrator once per month, Administrator is not present.

During record review and interview with Administrator Assistant, direct care staff have no documented training on file.

During record review, LPAs observed R2 has a medical assessment signed by a nurse practitioner, not a physician.

During interviews conducted with R2 & R3, they stated that they are not receiving mail. During records review of resident files LPAs observed unopened mail for R5 in their file.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, deficiencies are being cited on the attached 809D. If not corrected, the violations will have a direct and immediate risk to the health, safety and or personal rights of residents in care. An immediate civil penalty in the amount of $500 is hereby assessed for care and supervision. Issuance of additional civil penalties, if any, are pending and currently under review.

Exit interview conducted with Administrator Assistant and Administrator via telephone. Plans of corrections were developed by Elsa Nguyen and reviewed by LPAs. Appeal rights and a copy of this report were provided at the visit.
NAME OF LICENSING PROGRAM MANAGER: Sergiy Pidgirny
NAME OF LICENSING PROGRAM ANALYST: Melinda Medina
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC809 (FAS) - (06/04)
Page: 6 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 04:03 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
HSC
1569.2(c)

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(c) “Care and supervision” means the facility assumes responsibility for, or provides or promises to provide in the future, ongoing assistance with activities of daily living without which the resident’s physical health, mental health, safety, or welfare would be endangered. Assistance includes assistance
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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with taking medications, money management, or personal care. **This was not met as evidenced by interview with residents and administrator there was an incident involving law enforcement on site searching for a suspect, the suspect had entered and was hiding in R6's home.
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Type A
11/19/2025
Section Cited
CCR87405(a)

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Administrator Qualifications: a)All facilities shall have a qualified and currently certified administrator. The licensee and the administrator may be one and the same person. The administrator shall have sufficient freedom from other responsibilities and shall be on the premises a sufficient number of hours to permit adequate attention to the management and administration of the facility as specified
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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in this section. When the administrator is not in the facility, there shall be coverage by a designated substitute who shall have qualifications adequate to be responsible and accountable for management and administration of the facility as specified in this section. The Department may require that the administrator devote additional hours in the facility to fulfill his/her responsibilities when the need for such additional hours is substantiated by written documentation.**This was not met as evidenced by Adminstrator has not been available in person with LPAs for 3 visits on 10/14/25, 10/30/25 & 11/0525. Interviews with residents state they may see Administrator once per month, Administrator is not present.
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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.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 04:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/21/2025
Section Cited
CCR
8411(c)

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Personnel Requirements - General:
All RCFE staff who assist residents with personal activities of daily living shall receive initial and annual training as specified in Health and Safety Code sections 1569.625 and 1569.69
**This was not met as evidenced by, based on record review and interview with Administrator Assistant, direct care staff have no documented training on file.
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Administrator to submit training records for all staff to Fresno Regional office by plan of correction due date
Type B
11/21/2025
Section Cited
CCR
87411(d)

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Personnel Requirements - General:
All personnel shall be given on the job training or have related experience in the job assigned to them. This training and/or related experience shall provide knowledge of and skill in the following, as appropriate for the job assigned and as evidenced by safe and effective job performance:
**This was not met as evidenced by, based on record rerview and interview with Administrator Assistant, direct care staff have no documented training on file.
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Administrator to submit training records for all staff to Fresno Regional office by plan of correction due date
Type B
11/21/2025
Section Cited
CCR87209(a)(2)

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Program Flexibility: a)The use of alternate concepts, programs, services, procedures, techniques, equipment, space, personnel qualifications or staffing ratios, or the conduct of experimental or demonstration projects shall not be prohibited by these regulations provided that: (2) A written request for a waiver or exception and substantiating evidence supporting the request shall be submitted in advance to the licensing agency by the applicant or licensee.
**This was not met as evidenced by, R2 has a medical assessment signed by a nurse practioner, not a physician,
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Type B
11/19/2025
Section Cited
CCR
87468.1(a)(15)

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Personal Rights of Residents in All Facilities: (a)Residents in all residential care facilities for the elderly shall have all of the following personal rights: (15) To send and receive unopened correspondence in a prompt manner.
**This was not met as evidenced by, interviews conducted with R2 & R3 who stated that they are not receiving mail. During records review of resident files LPAs observed unopened mail for R5 in their file.

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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
Page: 8 of 9
Document Has Been Signed on 11/05/2025 07:13 PM - It Cannot Be Edited


Created By: Melinda Medina On 11/05/2025 at 04:48 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: HELPING HANDS SENIOR CARE
FACILITY NUMBER: 107209444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/21/2025
Section Cited
CCR
87468.2(a)(9)

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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities (a) In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:
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Administrator will provide training to staff and submit agenda and sign in sheets to Fresno Regional Office by plan of correction due date.
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(9) To present grievances and recommend changes in policies, procedures, and services to the facility staff, management, and governing authority, and to any other person without restraint, coercion, discrimination, reprisal, or other retaliatory actions..**Thiis requirement was not as evidenced by LPAs interviews, licensee stated R4 brought problems to the facility and needs to find another place to live.
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Type B
11/21/2025
Section Cited
CCR87221

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87221 Resident Councils
The facility shall permit the formation of a resident council by interested residents, provide space and post notice for meetings, and provide assistance in attending meetings for those residents who request it. In order to permit a free exchange of ideas, at least part of each meeting shall be allowed to be conducted without the presence of any facility personnel. Residents shall be encouraged, but shall not be compelled to attend. The purpose of such an organization shall be to work with the administration in improving the quality of life for all residents by enriching the activity program and to discuss the services offered by the facility and make recommendations regarding identified problems.
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Administrator to submit written plan to Fresno Regional office to remain in compliance with Title 22 regulation
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This requirement was not met as evidenced by LPAs interviews with residents and records review. There has been no notice or resident council formed.
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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.
Sergiy Pidgirny
NAME OF LICENSING PROGRAM MANAGER:
Melinda Medina
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2025


LIC809 (FAS) - (06/04)
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