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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
157203276
Report Date:
02/05/2025
Date Signed:
02/14/2025 07:04:51 AM
Document Has Been Signed on
02/14/2025 07:04 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
,
1314 E SHAW AVE
FRESNO
,
CA
93710
FACILITY NAME:
MCCLELLAN BOARD & CARE FACILITY #2
FACILITY NUMBER:
157203276
ADMINISTRATOR/
DIRECTOR:
GALICIA, RUDOLPHO
FACILITY TYPE:
735
ADDRESS:
825 FOXTREE COURT
TELEPHONE:
(661) 366-7864
CITY:
BAKERSFIELD
STATE:
CA
ZIP CODE:
93306
CAPACITY:
5
CENSUS:
DATE:
02/05/2025
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:
TIME VISIT/
INSPECTION COMPLETED:
09:47 AM
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SUPERVISORS NAME
:
Sergiy Pidgirny
LICENSING EVALUATOR NAME
:
Shawna Doucette
LICENSING EVALUATOR SIGNATURE
:
DATE:
02/05/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/05/2025
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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