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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202769
Report Date: 01/22/2025
Date Signed: 01/22/2025 03:59:24 PM

Document Has Been Signed on 01/22/2025 03:59 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:CARRINGTON OF SHAFTERFACILITY NUMBER:
157202769
ADMINISTRATOR/
DIRECTOR:
ALICIA WEBBFACILITY TYPE:
740
ADDRESS:250 EAST TULARE AVENUETELEPHONE:
(661) 746-6521
CITY:SHAFTERSTATE: CAZIP CODE:
93263
CAPACITY: 64TOTAL ENROLLED CHILDREN: 0CENSUS: 46DATE:
01/22/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:41 AM
MET WITH:Amanda JaimeTIME VISIT/
INSPECTION COMPLETED:
04:12 PM
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On 1/22/2025, Licensing Program Analyst (LPA) Melinda Medina conducted an unannounced Annual Required inspection. LPA arrived, introduced self, stated purpose of visit and allowed entrance. LPA conducted facility tour with Interim Administrator, Amanda Jaime.

Facility observed to be well lit and a comfortable temperature. Facility tour began in resident bedrooms. LPA toured bedrooms 2, 11, 14, 22, 26, 35, 41, and 42. All resident bedrooms observed to have required furnishings. All resident bedrooms observed to have private bathrooms with showers, fixtures observed operational and equipped with grab bars, shower chairs, and non-skid surfaces. Water temperature measured between 111-117 degrees F in bedrooms toured. All common areas, sun room, activities room and dining room were toured. LPA observed adequate seating and lighting for residents throughout facility. LPA observed residents participating in different activities throughout facility tour. The kitchen was toured. LPA observed supplies of nonperishable foods for a minimum of one week and perishable foods for a minimum of two days. Menus observed to be posted and available for residents posted on bulletin board.. Medications observed to be locked in medication room and inaccessible to residents. Medications reviewed and observed to have original labeled and to be administered as prescribed by physician.

Indoor and outdoor passageways open free of obstructions. Fire extinguishers present with a service date of 5/10/2024..

LPA received updated LIC 308, LIC 500 and LIC 9020 during facility inspection. .

No deficiencies cited during inspection. Exit interview conducted and a copy of this provided for facility records.
Melinda HoffmannTELEPHONE: (559) 341-3247
Melinda MedinaTELEPHONE: (559) 410-5914
DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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