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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202907
Report Date: 10/21/2024
Date Signed: 10/21/2024 10:19:45 AM

Document Has Been Signed on 10/21/2024 10:19 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:HALF MOON HOMEFACILITY NUMBER:
157202907
ADMINISTRATOR/
DIRECTOR:		GLENN, RHONDAFACILITY TYPE:
735
ADDRESS:3509 SOUTH HALF MOON DRIVETELEPHONE:
(661) 833-6333
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 6CENSUS: 5DATE:
10/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:House Manager Sharon JohnsTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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Licensing Program Analyst LPA Shawna Doucette arrived at the facility unannounced and conducted an Annual Inspection on this date. LPA was met by House Manager Sharon Johns.

LPA conducted a tour inside and outside of facility. Facility observed to be clean, and at a comfortable temperature. Common areas were furnished well with adequate seating and lighting available. Kitchen toured, appeared clean and safe for food preparation. Food supply checked, LPA observed an adequate supply of food.

Resident rooms checked. LPA observed an adequate supply of linen. Hot water measured at 110.4 degrees F. Facility was set at 72 F. Medications were locked in a kitchen cabinet.

Exterior tour conducted, all exits open and free of obstructions. Side gate was observed to be self-latching.

Fire extinguisher serviced on 05/10/2024. Smoke detectors and carbon monoxide detectors observed operational during today’s inspection. Last fire drill conducted 7/15/2024. All cleaning supplies are locked in a cabinet in the in the dining room.

LPA reviewed resident and staff files.

An exit interview was conducted and a copy of this report was provided.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2024
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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