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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808928
Report Date: 10/24/2019
Date Signed: 10/24/2019 01:46:23 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:SPECIAL EXPLORERS CENTERFACILITY NUMBER:
153808928
ADMINISTRATOR:BOWDEN, DAMIANFACILITY TYPE:
840
ADDRESS:401 19TH STREETTELEPHONE:
(661) 703-9176
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY:30CENSUS: 5DATE:
10/24/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Joe Correa - Operations ManagerTIME COMPLETED:
02:00 PM
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On this date, Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced case management inspection at the facility. LPA met with Operations Manager Joe Correa to discuss two individual Confirmation of Removal forms that were mailed to the Licensee's mailing address from Department of Social Services, Caregiver Background Check Bureau, regarding Adult #1 and Adult #2. LPA toured the facility and a census was taken.

LPA provided Mr. Correa a copy of Confirmation of Removal forms for both Adult #1 and Adult #2. Mr. Correa indicated that neither individual was ever hired, nor have they been on the premises. LPA informed Mr. Correa that the Department has denied the criminal record exemption for Adult #1. Mr. Correa understands that Adult #1 is not allowed on the premises, or around children in care, in any capacity.

Mr. Correa was informed that an exemption is required for Adult #2. Mr. Correa stated that the licensee will not be requesting an exemption for Adult #2. Mr. Correa understands that this individual is not allowed on the premises, or around children in care, in any capacity.

Based on evidence obtained during today’s visit, LPA has verified the Adult #1, and Adult #2 are not present or employed at the facility. LPA has advised Ms. Correa to disassociate both individuals from the Facility Personnel Report. Verification of removal is complete.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies cited.

An exit interview conducted with Operations Manager Joe Correa. A copy of this report was provided and discussed.

A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2019
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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