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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202532
Report Date: 05/15/2025
Date Signed: 05/16/2025 10:45:46 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/16/2025 10:45 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:KERN TRANSITION HOME-RIVER GLENFACILITY NUMBER:
157202532
ADMINISTRATOR/
DIRECTOR:		FRAZIER, BRANDYFACILITY TYPE:
735
ADDRESS:4409 RIVER GLEN DRIVETELEPHONE:
(661) 213-3800
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 4CENSUS: 4DATE:
05/15/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
05:30 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
09:00 PM
NARRATIVE
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On 05/15/25, Licensing Program Analysts (LPAs) L. Salazar and S. Hurt arrived at the facility unannounced to conduct an annual continuation visit to review facility staff and client records. LPAs were greeted by staff, stated the purpose of the visit and were allowed entry into the facility. LPAs met with Program Director(PD)/Administrator during the visit. Administrator on record is Brandy Frazier.

LPAs observed four residents home and five staff members present. LPAs' reviewed a sample of staff files and observed Staff S1 does not have a personnel file available to review. LPAs' verified S1 is fingerprint cleared and associated to the facility. S1 showed proof of TB test/clearance. Staff 2 does not have required current Emergency Intervention training.

Resident 1's (R1) recent Physicians report (LIC602) is not consistent with prior reports dated in 2019, 2021, 2022, 2023. Prior reports dated 2019-2023 have (five) primary diagnosis' / four secondary diagnosis'. R1's Physicians report dated 2024 has only one primary diagnosis, and one secondary diagnosis. 2 of 2 resident files reviewed did not have the required Regional Center written certification, which states that there was no objection to the placement by any persons specified in Welfare and Institutions Code Section 4803. R1 does not have the required annual updated Needs and Services plan in file (Individual Performance Plan or current dated Behavioral Functional Assessment).

Due to time, LPAs concluded inspection. Per California Code of Regulations, Title 22, Division 6, Chapter 8, a deficiencies are being cited on the attached 809-D. If not corrected, this poses an potential risk to the health safety and personal rights of residents in care.

An exit interview was conducted with PD. A plan of correction was developed by PD and reviewed with LPAs. A copy of this report and appeal rights were provided at the time of the visit.
NAME OF LICENSING PROGRAM MANAGER: Melinda Hoffmann
NAME OF LICENSING PROGRAM ANALYST: Lisa Salazar
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/16/2025 10:45 AM - It Cannot Be Edited


Created By: Lisa Salazar On 05/15/2025 at 07:27 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: KERN TRANSITION HOME-RIVER GLEN
FACILITY NUMBER: 157202532

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2025
Section Cited
CCR
80069(d)(1)

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80069 Medical Assessment
(d) In addition to Section 80069(c), the medical assessment for clients in ARFs shall include the following: (1) A physical examination of the person, indicating the physician's primary diagnosis and secondary diagnosis, if any.
The following requirement has not been met as evidenced by:
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Program Director will provide updated Physicians report for resident 1 and submit to LPA by POC date of 05/30/2025.
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Resident R1's 2024 Physician's report (LIC 602) does not consistent diagnosis' with the 2019, 2021, 2022, 2023 LIC 602's. 2024 has one primary diagnosis, and one secondary diagnosis. Previous reports show five primary diagnosis' & four secondary diagnosis', which poses a potential, health, safety ,or personal rights risk to residents in care.
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Type B
05/30/2025
Section Cited
CCR80068.3(a)

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80068.3 Modifications to Needs and Services Plan
(a) The licensee shall ensure that each client's written Needs and Services Plan is updated as often as necessary to assure its accuracy, but at least annually. These modifications shall be maintained in the client's file. The following requirement has not been met as evidenced by:
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Program Director will update Resident R1's Needs and Services plan and send to LPA via email by POC date of 05/30/2025.
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Resident R1 does not have the required annually updated Needs and Services plan, which poses a potential health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Melinda Hoffmann
NAME OF LICENSING PROGRAM MANAGER:
Lisa Salazar
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2025 10:45 AM - It Cannot Be Edited


Created By: Lisa Salazar On 05/15/2025 at 07:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: KERN TRANSITION HOME-RIVER GLEN
FACILITY NUMBER: 157202532

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/30/2025
Section Cited
CCR
80068(a)(1)

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80068 Admission Agreements(a)
The licensee shall complete an individual written admission agreement with each client and the client's authorized representative, if any. (1) Prior to admitting a developmentally disabled adult recommended by a Regional Center, the licensee of an ARF shall obtain from the Regional Center written certification which states that there was no objection to the placement by any persons specified in Welfare and Institutions Code Section 4803. The following requirement has not been met as evidenced by:
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Administrator will provide written certification from Regional Center which states there in no objection to placement to LPA via email by POC date 05/30/2025.
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LPAs observation of records review, 2 out of 2 residents do not have the required written certification from regional center which states that there was no objection to the placement by any persons specified in Welfare and Institutions Code Section 4803. This poses a potential, health, safety, or personal rights risk to residents in care.
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Type B
05/30/2025
Section Cited
CCR80066(a)

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80066 Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: The following requirement has not been as evidenced by:
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Adminstrator will provide file for staff 1 to LPA via email by POC date of 05/30/2025.
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Staff 1 does not have Personnel record avaialble for review, which poses a potential, health, safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Melinda Hoffmann
NAME OF LICENSING PROGRAM MANAGER:
Lisa Salazar
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2025


LIC809 (FAS) - (06/04)
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