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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808523
Report Date: 10/30/2019
Date Signed: 10/30/2019 02:18:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VALLEY ACHIEVEMENT CENTERFACILITY NUMBER:
153808523
ADMINISTRATOR:VEJAR, TIFFANYFACILITY TYPE:
840
ADDRESS:1300 STINE ROADTELEPHONE:
(661) 617-6040
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:114CENSUS: 0DATE:
10/30/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Site Facilitator, Juanita SanchezTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Jose Penate conducted a Case Management - Incident inspection for an incident which occurred on 10/10/2019. LPA met with Site Supervisor, Tiffany Vejar and Site Facilitator, Juanita Sanchez. LPA toured facility inside and outside and took census.

On 10/10/2019 Child #1 began to throw her body onto the ground, kicking. Staff could not get client into compliance. Staff did a Reverse Transport (2 staff members walk a child backwards) into the cool down room. Two female staff members were always with the child during the incident.

LPA Penate spoke with Tiffany and she explained the definition of Reverse Transport. Tiffany presented LPA with the directions that are presented to staff with different variations of transport methods to be utilized for clients in care when they might harm themselves or others.

Reverse Transport is used with a person that may make it difficult to move using the Forward Transport method. In that case, if it is necessary that the person be moved, the Reverse Transport may provide an effective alternative. The Reverse Transport may not be appropriate for persons who are significantly stronger or taller than staff. It is recommended that transports be limited to short distances.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

Site Visit Notice posted on the parent board.

Exit interview was conducted with Site Facilitator, Juanita Sanchez.

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2019
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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