<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203139
Report Date: 07/22/2024
Date Signed: 07/22/2024 02:39:25 PM

Document Has Been Signed on 07/22/2024 02:39 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:KERN TRANSITION HOME-MEADOW OAKSFACILITY NUMBER:
157203139
ADMINISTRATOR/
DIRECTOR:		MANIGQUE, LESTERFACILITY TYPE:
735
ADDRESS:5813 MEADOW OAKS COURTTELEPHONE:
(661) 871-7410
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 4CENSUS: 4DATE:
07/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:41 PM
MET WITH:Administrator Lester ManigqueTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPA) Shawna Doucette contacted the facility to commence a case management for an incident that occurred on 5/31/24 and on 06/25/24. LPA met with Administrator Lester Manigque.


On 5/31/24 C1 needed a change of clothes due to being soiled. Facility Administrator was contacted by day program at 11:45 AM. Facility Administrator had difficulty finding staff to respond to pick up or provide additional clothing for C1 and did not get to the day program until about 02:07 PM. Refer to 809d for personal rights violation.

On 06/25/24 C2 AWOL'd from the facility. Administrator stated facility staff did not lose eye contact with C2. Administrator stated C2 was upset because the house was to cold. Administrator stated C2 was outside of the facility for about a total of 10 minutes and staff was with C2 redirecting C2 to return to the facility. No deficiencies for 06/25/24 incident.

Administrator was provided a copy of this report with plan of correction and appeal rights.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/22/2024 02:39 PM - It Cannot Be Edited


Created By: Shawna Doucette On 07/22/2024 at 12:58 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-MEADOW OAKS
FACILITY NUMBER: 157203139

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/26/2024
Section Cited
CCR
80072(a)(3)

1
2
3
4
5
6
7

80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule,
1
2
3
4
5
6
7
Plan of Correction: Licensee agrees
8
9
10
11
12
13
14
humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was met as evidenced by: Licensee did not provide a change of clothes or pick C1 up from day program in a timely manner after C1 solied her clothing which poses an immediate health safety and or personal rights risk to clients in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Sergiy Pidgirny
LICENSING EVALUATOR NAME:Shawna Doucette
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2