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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 107204173
Report Date: 07/01/2026
Date Signed: 07/01/2026 04:15:35 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
06/30/2026 and conducted by Evaluator Daiquiri Boyd
COMPLAINT CONTROL NUMBER: 24-AS-20260630095454
FACILITY NAME:FRESNO GUEST HOME #5FACILITY NUMBER:
107204173
ADMINISTRATOR:KUTNERIAN, ANGELICAFACILITY TYPE:
740
ADDRESS:2776 E. MAGILLTELEPHONE:
(559) 434-1839
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:6CENSUS: 6DATE:
07/01/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Teresa LongTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit resident in care resulting in bruising
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPA) Daiquiri Boyd and Hou Vang conducted the complaint investigation visit to the facility. During this visit LPAs delivered investigation findings regarding the above allegation. The Department has investigated the complaint alleging: staff hit resident in care resulting in bruising. Based on the interviews conducted and/or records review the above allegation is UNSUBSTANTIATED. Interviews with staff and family revealed that stories were not consistant and pictures taken of resident that day showed no bruising. 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Shawna Doucette
LICENSING EVALUATOR NAME: Daiquiri Boyd
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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