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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203395
Report Date: 12/07/2021
Date Signed: 12/07/2021 11:40:13 AM

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:BROOKDALE RIVERWALKFACILITY NUMBER:
157203395
ADMINISTRATOR:WEBSTER, REGFACILITY TYPE:
741
ADDRESS:350 CALLOWAY DRTELEPHONE:
(661) 587-0221
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:376CENSUS: DATE:
12/07/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
10:46 AM
MET WITH:Administrator, Reg WebsterTIME COMPLETED:
11:38 AM
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Licensing Program Analyst (LPA) Darius Williams conducted an unannounced visit in response to a death report received from the facility on 12/6/2021. LPA Williams met with Administrator, Reg Webster and discussed the purpose of the visit.

LPA Williams toured Building A and Building B with the Administrator.

LPA Williams observed all staff wearing masks. The facility was clean, free of odor, and in good repair. Residents were observed eating in the dining hall, participating in extra activities, socializing in the common areas, and exercising in the gym.

Chemicals and medications were stored behind locked doors.

The Administrator reported counseling services are being offered to staff and residents.

LPA Williams received copies of Resident 1's documents.

No deficiencies were observed at this time.

An exit interview was conducted and a copy of this report was provided.
SUPERVISOR'S NAME: Serigy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Darius WilliamsTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2021
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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