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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202389
Report Date: 09/25/2024
Date Signed: 09/25/2024 08:44:14 PM

Document Has Been Signed on 09/25/2024 08:44 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:KREBS RANCH HOMEFACILITY NUMBER:
157202389
ADMINISTRATOR/
DIRECTOR:		MCCRAW, CHERYLFACILITY TYPE:
735
ADDRESS:6304 KREBS RDTELEPHONE:
(661) 587-5290
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 2CENSUS: 2DATE:
09/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Administrator Cheryl McCrawTIME VISIT/
INSPECTION COMPLETED:
12:11 PM
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On 09/25/24, Licensing Program Analysts (LPAs) L. Salazar and M. Medina arrived to the facility unannounced to conduct the required annual inspection. LPAs were greeted by staff, stated the purpose of the visit and were allowed entry into the facility. Administrator arrived to the facility shortly after LPAs' arrival. Administrator on record is Cheryl McCraw, Certificate# 6016103735, Exp. 05/

LPA Medina toured the facility inside and out with Staff S1 and will document observations on a separate report. LPA Salazar completed the records review and inspection tool.

Residents’ files were reviewed and observed to have update emergency contacts, Admission agreement, and current physician report/individual performance plans (IPP). P&I records were observed to be balanced and cash accounted for. A sample of staff files were also reviewed. Staff files were observed to have current First Aid/CPR. Staff are fingerprinted clear and associated to the facility.

Quarterly Emergency Disaster Drill logs were observed for staff. LPA observed on the LIC 610D (Emergency Disaster Plan) with emergency numbers and evacuations locations were posted in the entry.

An exit interview was conducted with Administrator. A copy of this report was discussed and provided at the time of visit. No deficiencies cited on today's visit.

The following documents are requested and submitted to Fresno CCL by: 10/11/24:


LIC 308, LIC309, LIC 400, LIC 402, LIC 500, LIC 610D,
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2024
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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