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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107206861
Report Date: 06/28/2024
Date Signed: 06/28/2024 01:53:19 PM

Document Has Been Signed on 06/28/2024 01:53 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:BELMAR VILLAFACILITY NUMBER:
107206861
ADMINISTRATOR/
DIRECTOR:
HRIPSIME MAKARYANFACILITY TYPE:
740
ADDRESS:2020 NORTH WEBER AVENUETELEPHONE:
(559) 486-5977
CITY:FRESNOSTATE: CAZIP CODE:
93705
CAPACITY: 100CENSUS: DATE:
06/28/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:57 PM
MET WITH:Hripsime "Kristina" MakaryanTIME VISIT/
INSPECTION COMPLETED:
02:13 PM
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On or about today's date, an office meeting was conducted at the Fresno Adult and Senior Regional Office. Present during the meeting are: Administrator, Kristina Makaryan, on the phone is facility President of the Marina Isounts, LPA Les Xiong and LPM Melinda Hoffmann. The meeting was scheduled due to the number of complaints and deficiencies the facility has had over the past year, three of which were type A deficiencies. The issues discussed during the meeting were: Lack of supervision, full bedrails, facility not maintained and sanitary, facility not meeting resident's care needs, staff not providing comfortable accommodations, staff not addressing resident's change of condition and no home health care plan for resident.

Community Care Licensing would like to offer the facility Technical Support (TSP) if interested, to bring the facility back into substantial compliance.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
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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