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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107208986
Report Date: 03/21/2023
Date Signed: 03/21/2023 02:08:09 PM

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
12/30/2022 and conducted by Evaluator Melinda Medina
COMPLAINT CONTROL NUMBER: 24-AS-20221230143820
FACILITY NAME:FRESNO GUEST HOME XIIFACILITY NUMBER:
107208986
ADMINISTRATOR:KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:2398 E. LOS ALTOS AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 5DATE:
03/21/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:George Kutnerian
Angela Kutnerian		TIME COMPLETED:
02:18 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff failed to seek medical attention for resident
Facility does not have awake night staff
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/21/23, Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct a complaint investigation. LPA introduced self, stated the purpose of the visit. LPA met with Administrators, George Kutnerian and Angela Kutnerian

LPA received toured facility, conducted interviews, and reviewed documentation received. Per review of resident physician reports, no residents residing in facility have tendency to wander therefore regulation does not require facility to have awake staff during the night. During interview with R1 responsible party, LPA was informed that R1 was relocated to facility due to excess contact with 911 services for non-emergency situations.

This Department investigated the complaint alleging facility staff failed to seek medical attention for resident and facility does not have awake night staff. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023
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 1