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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203233
Report Date: 06/23/2022
Date Signed: 06/23/2022 10:42:20 AM

Document Has Been Signed on 06/23/2022 10:42 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:N.A.P.D. MELANIE BELL-KENNEMER ADULT ENRICH CTR.FACILITY NUMBER:
157203233
ADMINISTRATOR:HERNANDEZ, EVELYNFACILITY TYPE:
775
ADDRESS:3720 N. SILLECT AVE.TELEPHONE:
(661) 324-9854
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 210CENSUS: 27DATE:
06/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:18 AM
MET WITH:Administrator, Maria MontesTIME COMPLETED:
10:55 AM
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On 06/23/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Maria Montes. Facility has one central entry and exit. Facility has implemented a sign in policy for clients and visitors, but has not initiated a symptom screening for clients and visitors entering the facility.

LPA conducted a facility tour with Administrator. The facility appeared clean with no fire clearance issues. Signs have been posted throughout the facility to promote hand-washing, cough/sneeze etiquette, and physical distancing. Hand sanitizer was readily available to clients, staff and visitors. Clients are placed in designated cohorts and staff interactions are limited to the staff assigned to the same cohort. The facility has a designated visitation room and isolation room. Hand-washing posters were observed by the bathroom sinks. Bathrooms were stocked with paper towels and liquid soap.

LPA observed an adequate supply of PPE and clients bring their own meals and medications. Staff were observed to be wearing facial coverings. Client records did not have updated emergency contact information.

LPA is requesting the following documents be submitted to the Fresno CCL Office by 07/07/2022: Designation of Facility Responsibility, Administrative Organization, Emergency and Disaster Plan, Personnel Report, Client Roster and current copy of the Administrator's certificate.

No deficiencies issued during today's visit. Exit interview conducted. A copy of this report was discussed and provided to Administrator, Maria Montes, whose signature on this form confirms receipt of this document.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 06/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2022
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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