157200752-10-12-2023-24-AS-SDOE-CWJSEW-20231012134924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 157200752
Report Date: 10/12/2023
Date Signed: 10/12/2023 01:49:27 PM

Document Has Been Signed on 10/12/2023 01:49 PM - 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:	RIVERSIDE RANCH, ADULT OUTPATIENT SERVICES		FACILITY NUMBER:	157200752
ADMINISTRATOR:	MORENO, ELANA		FACILITY TYPE:	775
ADDRESS:	18200 HIGHWAY 178		TELEPHONE:	(661) 871-9697
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93306
CAPACITY: 15		CENSUS: 10	DATE:	10/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Administrator Laura Vargas		TIME COMPLETED:	12:15 PM

NARRATIVE

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Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Laura Vargas. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Administrator.

A tour of the facility was conducted with the Administrator. The facility was free of passageway obstructions inside and outside.

LPA Doucette toured the facility. Hot water temperature was measured at 116.3 F.

Kitchen was toured. Knives were locked in a kitchen drawer.Cleaning supplies were in a locked in a cabinet under the kitchen sink. Medications are not administered at day program. First Aid Kit contained the required supplies. Smoke detectors and carbon monoxide detectors were checked. Fire extinguishers were charged and had service dates of 8/23/23. Fire drill was last completed on 08/25/23.

There was outdoor seating for the residents.

Staff records were reviewed. Resident records were reviewed. Records were found to be complete. Current first aid and CPR were on file for staff.

An exit interview was conducted with the Administrator. A copy of this report was discussed and left with the Administrator, Laura Vargas, whose signature on this form confirm receipt of these documents.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023

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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