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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203361
Report Date: 06/19/2023
Date Signed: 06/20/2023 10:51:01 AM

Document Has Been Signed on 06/20/2023 10:51 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:SUMMER HOMEFACILITY NUMBER:
157203361
ADMINISTRATOR:TIMBREZA, JHOSANFACILITY TYPE:
735
ADDRESS:8719 HOODSPORT AVENUETELEPHONE:
(661) 589-4001
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 4CENSUS: 4DATE:
06/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Ofelia NebridaTIME COMPLETED:
03:44 PM
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Licensing Program Analyst (LPA) M. Medina arrived unannounced to conduct the Annual Inspection. LPA met with and explained the purpose of the visit with Administrator, Ofelia Nebrida.

Currently 4 residents in placement, all residents were at day program at time of visit. Residents attend day program Monday through Friday 7:00 am - 3:00 pm.

During this visit, LPA toured the facility inside & out. Resident bedrooms contained required furnishings and lighting. LPA observed required items in bathrooms with hot water measuring 106 degrees F. Resident hygiene supplies were properly stored and available. The kitchen was observed to be clean, in good repair with necessary items and appliances. LPA observed required food supply and paper products. Knives, cleaning/disinfecting supplies and chemicals are locked and stored separate from food. Medications are centrally stored and locked. First aid kit contained required items. Facility has designated areas for visitors. Outside of the facility toured. LPA observed a self-releasing gate and windows have screens in good repair. Doors and passageways observed to be free of obstruction. Fire Extinguishers dated 8/21/22. Smoke and Carbon Monoxide detectors present and in working order. LPA conducted resident and staff file reviews. Staff were interviewed.

No deficiencies observed during today's inspection.

An exit interview was conducted with Administrator. A copy of this report provided for facility records.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2023
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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