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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107209272
Report Date: 05/19/2025
Date Signed: 05/19/2025 12:47:27 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
05/15/2025 and conducted by Evaluator Daiquiri Boyd
COMPLAINT CONTROL NUMBER: 24-AS-20250515104730
FACILITY NAME:FRESNO GUEST HOME #18FACILITY NUMBER:
107209272
ADMINISTRATOR:KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:2804 E. PALO ALTO AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 6DATE:
05/19/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Teresa LongTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not provide food of good quality
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Daiquiri Boyd made an unannounced visit to the Resident Care Facility for the Elderly (RCFE) and met with staff, who then called Administrator, Teresa Long.
LPA was greeted by facility staff and was granted entrance into the faciity. Residents were in their rooms and watching television in the living room and some had just finished breakfast. LPA toured the faciity and interviewed Administrator and resident. LPA looked at food supply and found it to be in good and sufficient supply and of good quality. Hot pasta lunch and a salad was currently being provided for lunch this day.
During this visit LPA delivered investigation findings regarding the above allegations. The Department has investigated the complaint alleging: staff do not provide food of good quality. Based on the interviews conducted and/or observation the above allegation is UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated.
No deficiencies were sited during this visit.
Exit interview conducted and copy of this report provided to Administrator for facility records.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Daiquiri Boyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2025
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO RO, 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
05/15/2025 and conducted by Evaluator Daiquiri Boyd
COMPLAINT CONTROL NUMBER: 24-AS-20250515104730

FACILITY NAME:FRESNO GUEST HOME #18FACILITY NUMBER:
107209272
ADMINISTRATOR:KUTNERIAN, GEORGEFACILITY TYPE:
740
ADDRESS:2804 E. PALO ALTO AVENUETELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 6DATE:
05/19/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Teresa LongTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is not providing an area for residents to smoke
Staff did not re-order resident's Nicorette patch
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Daiquiri Boyd made an unannounced visit to the Resident Care Facility for the Elderly (RCFE) and met with staff, who then called Administrator, Teresa Long.
LPA was greeted by facility staff and was granted entrance into the faciity. Residents were in their rooms and watching television in the living room and some had just finished breakfast. LPA toured the faciity and interviewed Administrator and resident. LPA obtained copies of the residents prescriptions, verifying that the Nicorette patch had expired and were no longer prescribed. LPA spoke with resident and he had not expressed that he wanted to start smoking again, only that he wanted another patch. Resident was made aware of the smoking area and the restrictions with the current residents that are on oxygen. LPA verified that all NO SMOKING signage is in place at the faciltiy.
Based on interviews and observations, it was determined that the above allegation: Licensee is not providing an area for residents to smoke and staff did not re-order resdient's Nocorette patch, is UNFOUNDED. This agency has investigated the complaint. We have found that the complaint was unfounded, therefore we have dismissed the complaint.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Daiquiri Boyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 2