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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700702
Report Date: 11/17/2022
Date Signed: 11/17/2022 01:18:46 PM

Document Has Been Signed on 11/17/2022 01:18 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:PAULSON COMMUNITY- SIERRA HOME, THEFACILITY NUMBER:
502700702
ADMINISTRATOR:HEKIMIAN, ARENFACILITY TYPE:
735
ADDRESS:2806 PAULSON RDTELEPHONE:
(559) 228-3056
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY: 5CENSUS: 4DATE:
11/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:CEO/Administrator, Vartan HekimianTIME COMPLETED:
01:30 PM
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Licensing program Analyst (LPA) Jason Lund arrived at the above facility’s unannounced to conduct annual/required visit. LPA met with the CEO/Administrator, Vartan Hekimian and explained the reason for the visit.

LPA Lund toured/ inspected the three facilities inside and outside. The facility has a staff office area, an area for an day program. Each facility has 5 resident rooms with a bathroom in each room. Each facility has an meeting area, dining area, computer area, health and wellness area and a laundry area. The client bathrooms have grab bars, paper towels and soap.

Each facility has an kitchen area with a sink, refrigerator and dishwasher. The medications are locked in the staff office. There is a delayed egress on each front door of the facility, side gate from the backyard and exterior gate in the common area of the facility.

There are designated cabinets for client’s belongings outside of each room. Fire extinguishers and smoke detectors are current and in compliance with fire safety.

Exit interview held with the CEO/Administrator, Vartan Hekimian and a copy of report given at the conclusion of the visit.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2022
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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