<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107206861
Report Date: 10/19/2021
Date Signed: 10/19/2021 10:52:01 AM

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
08/19/2021 and conducted by Evaluator Lady Cabrera
COMPLAINT CONTROL NUMBER: 24-AS-20210819092617
FACILITY NAME:BELMAR VILLAFACILITY NUMBER:
107206861
ADMINISTRATOR:HRIPSIME MAKARYANFACILITY TYPE:
740
ADDRESS:2020 NORTH WEBER AVENUETELEPHONE:
(559) 486-5977
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY:100CENSUS: 62DATE:
10/19/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Hripsime (Kristina) Makaryan, AdministratorTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has bed bugs
Meals are not provided
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Lady Cabrera conducted an unannounced subsequent complaint visit to the facility. During this visit LPA delivered investigation findings regarding the above allegations.

During this complaint investigation, LPA reviewed facility records relevant to the complaint investigation. Per records reviewed, on 07/14/2021, 07/28/2021, 08/11/2021 and 08/26/2021 EagleShield Pest Control serviced the facility. On 08/11/2021, EagleShield Pest Control inspected a total of six rooms due to residents were complaining about bedbugs. The conclusion of the inspection indicated no evidence of any bedbug activity or remains. On 08/31/2021 EagleShield conducted another inspection for bedbugs in Resident’s (R2) room and the facility’s laundry room. The conclusion of the inspection indicated no evidence of any bedbug activity or remains. Per staff interviews, there are no bedbugs in the facility.

On 08/26/2021, the complainant stated the allegation Meals are not provided was incorrect. The complainant reported facility is providing meals. Facility meals and snacks are provided daily by an outside vendor.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
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-20210819092617
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: BELMAR VILLA
FACILITY NUMBER: 107206861
VISIT DATE: 10/19/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on interviews and records review, this agency has investigated the complaint alleging, Facility has bed bugs and Meals are not provided. We have found that the complaint was unfounded, therefore we have dismissed the complaint.

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

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2