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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107209370
Report Date: 10/09/2024
Date Signed: 10/09/2024 11:43:31 AM

Document Has Been Signed on 10/09/2024 11:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:CHATEAU JESADEANFACILITY NUMBER:
107209370
ADMINISTRATOR/
DIRECTOR:		ROYCHOUDHURY, MINAKSHIFACILITY TYPE:
740
ADDRESS:5633 N MAROA AVENUETELEPHONE:
(559) 499-8229
CITY:FRESNOSTATE: CAZIP CODE:
93704
CAPACITY: 6CENSUS: 6DATE:
10/09/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:56 AM
MET WITH:Administrator, Minakshi RoychoudhuryTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 10/09/2024, a scheduled informal office meeting was conducted. The purpose of the informal meeting was to discuss recently identified issues associated with the operation of the facility and to provide support on the subject matter.

Present at the informal meeting:

Licensee, Rajat Roychoudhury
Administrator, Minakshi Roychoudhury
Administrator, Shailesh Patel

Licensing Program Analyst, Alexandria Walton
Licensing Program Manager, See Moua

This meeting was called to discuss the issues and deficiencies issued during the annual inspection regarding hospice care.

The Licensee was informed of Technical Support Program resources and a referral will be made on behalf of the facility.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Minakshi Roychoudhury, whose signature on this form confirm receipt of this document.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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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