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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208887
Report Date: 02/02/2026
Date Signed: 02/02/2026 12:44:33 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 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
01/26/2026 and conducted by Evaluator Mary Garza
COMPLAINT CONTROL NUMBER: 24-AS-20260126163939
FACILITY NAME:FIVE STAR ASSISTED LIVING CORPFACILITY NUMBER:
107208887
ADMINISTRATOR:OGANYAN, HASMIK JASMINEFACILITY TYPE:
740
ADDRESS:2573 W. BARSTOW AVETELEPHONE:
(559) 283-8543
CITY:FRESNOSTATE: CAZIP CODE:
93711
CAPACITY:6CENSUS: 6DATE:
02/02/2026
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee/Administrator, Jasmine OganyanTIME COMPLETED:
12:54 PM
ALLEGATION(S):
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Facility did not issue a refund to resident's responsible party.
INVESTIGATION FINDINGS:
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On 02/02/2026 Licensing Program Analyst (LPA) M. Garza arrived at the facility for an unannounced complaint visit. LPA met by Direct Care Staff, Esther and Henry Alsisto explained reason for visit and was permitted entry into the facility. Licensee/Administrator, Jasmine Oganyan was contacted and arrived some time later. A tour of the facility was completed. A health and safety check was completed on residents in care. Residents were observed in common area and in rooms. There are currently 6 residents present during todays visit. 1 of 6 is bedridden and 3 of 6 are receiving hospice services at this time.

During complaint investigation LPA completed interviews, reviewed admission agreements and incident reports. Interviews disclosed that R1 passed on 7/28/25 and their personal belongings were removed from the facility on 7/29/25. Licensee did not provide a refund to the responsible party as required by Title 22. Responsible party is owed a refund in the amount of $322.58. The preponderance of evidence standard has been met per California Code of Regulations, Title 22. The complaint allegation is SUBSTANTIATED. Deficiencies cited on attached 9099D. If not corrected, deficiencies will have a potential impact to residents in care.

Exit interview completed with Licensee, Jasmine. A copy of this report, deficiencies and appeal rights provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
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-20260126163939
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: FIVE STAR ASSISTED LIVING CORP
FACILITY NUMBER: 107208887
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/13/2026
Section Cited
HSC
1569.652
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1569.652 Termination of admission agreement upon death of resident; removal of resident’s property; refund of fees paid; notice of contract termination and refunds (c) A refund of any fees paid in advance covering the time after the resident’s personal property has been removed from the facility shall be issued to the individual, individuals, or entity contractually responsible for the fees or, if the deceased resident paid the fees, to the resident’s estate, within 15 days after the personal property is removed.
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Licensee stated they will provide a refund to the responsible party in the amount of $322.58 via certified mail. A copy of the receipt will be provided to CCL by POC date as proof of correction.
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This requirement was not met as evidence by: review of records and interviews completed. The licensee did not comply with the section cited above in that R1 passed on 7/28/25 and their belongings were removed from the facility on 7/29/25. Licensee did not provide a refund for the 2 days of the month that the resident did not reside at the facility in the amount of $322.58. This poses a potential health safety and or personal rights risk to residents in 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.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2