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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202442
Report Date: 04/18/2022
Date Signed: 04/19/2022 09:20:04 AM

Document Has Been Signed on 04/19/2022 09:20 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:ENDEAVOR IN THE WESTFACILITY NUMBER:
157202442
ADMINISTRATOR:ESPARZA, DANIELFACILITY TYPE:
735
ADDRESS:8114 RIVER HAWK LNTELEPHONE:
(661) 588-8966
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 4CENSUS: 4DATE:
04/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Administrator Daniel Esparza TIME COMPLETED:
10:00 AM
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On 04/18/22, Licensing Program Analyst (LPA) M. Yang arrived unannounced to conduct an Annual Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and requested to meet with Administrator. LPA met with caregiver Victoria Lajas. Administrator Daniel Esparza was called and arrived shortly. LPA conducted tour with administrator. All four clients present during tour.

Upon entry facility staffs was observed with facial mask. Visitor log-in/temperature check was observed upon entry. Hand sanitizer was readily available to clients and visitors. Facility has one entrance/exit point. Facility appeared cleaned with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. LPA observed social distancing etiquette postings in facility.

Food supply was checked and appeared to be an adequate supply. LPA observed fire extinguisher served date: 11/08/21. Last fire drill: 04/01/22. LPA observed hand washing posting by all sinks. Cleaning supplies were stored and locked under kitchen sink and in the garage. LPA checked clients’ locked medications and observed a 30-day PPE supplies. All clients’ room toured and observed to be adequately furnished and lit. LPA observed 4 bedrooms that are single occupant. All bathrooms observed trash bin with lid.

The exterior tour was conducted. Exit was open and free of obstructions. Staff records were reviewed for good health and infection control training. All clients’ records reviewed to have updated emergency contact information.

No deficiencies issued during this inspection.

Exit Interview conducted. The following documents are requested and submitted to Fresno CCL by: 04/25/22. The following updated forms were requested: Lic 308, Lic 309, Lic 400, Lic 402, Lic 500, Lic 9020, control of property. LPA received copy of Administrator Certificate and Lic 610D during facility inspection. Administrator was informed that as COVID-19 precautionary measure, this report will be provided via email. Report signed on site.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2022
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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