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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 140908720
Report Date: 06/21/2022
Date Signed: 06/22/2022 10:40:27 AM

Document Has Been Signed on 06/22/2022 10:40 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:PROGRESS HOUSE - INYO CO. COM. MENTAL HEALTH SVCS.FACILITY NUMBER:
140908720
ADMINISTRATOR:MCKINZEY, GINA AFACILITY TYPE:
735
ADDRESS:536 N. SECOND STREETTELEPHONE:
(760) 873-8572
CITY:BISHOPSTATE: CAZIP CODE:
93514
CAPACITY: 12CENSUS: 6DATE:
06/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:28 PM
MET WITH:House Manager Kelly NugentTIME COMPLETED:
03:30 PM
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Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Staff Robert Rubio and discussed the purpose of the visit. House Manager Kelly Nugent and LPA began the tour at the front entrance of the facility.

Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed to be locked in the office. LPA observed the following personal protective equipment in the office; hand sanitizer, face shields, gloves, and masks. Resident’s files have updated emergency contact information. Staff training was provided for Covid 19, but not documented.

No deficiencies were observed.

Exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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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