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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202442
Report Date: 03/22/2023
Date Signed: 03/22/2023 01:27:25 PM

Document Has Been Signed on 03/22/2023 01:27 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: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:
03/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:Eric CoronadoTIME COMPLETED:
01:58 PM
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On 3/22/23, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required inspection LPA introduced self and stated purpose of visit. LPA allowed entrance by Administrator, Eric Coronado. Daniel Esparaza was not available to conduct today's inspection.

Currently, 4 residents in placement. One resident was present during today's visit. All residents were at day program at time of inspection. Residents attend day program Monday - Friday 8:30 am - 2:30 pm.

LPA conducted a complete tour of the facility with Administrator. Facility was observed at a comfortable temperature, clean, in good repair. Resident rooms toured and observed to have required furnishings. Bathrooms observed in good repair and operational. Showers observed to be equipped with non-skid mats. Hot water was measured at 113 degrees F. Common areas were properly furnished and well-lit throughout. Kitchen observed to have adequate food supply for residents in care. All knives are locked and secured in kitchen drawer. Medications observed to be locked and secured in medication cart.

Smoke detectors and carbon monoxide detectors observed operational at time of inspection. Fire extinguisher has a service date of 11/21/22. Last fire drill conducted on 3/23/2023 according to facility records.

Outside toured. All exits open free of obstruction.

Administrator to submit copies of Administrator Certificate, CPR/First Aid, LIC 500, LIC 610 and LIC 9020 during inspection.

No deficiencies observed. Exit Interview conducted.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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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