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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157203994
Report Date: 06/08/2023
Date Signed: 06/08/2023 05:06:41 PM

Document Has Been Signed on 06/08/2023 05:06 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:SAILS IFACILITY NUMBER:
157203994
ADMINISTRATOR:DELGADILLO, JESSICAFACILITY TYPE:
735
ADDRESS:7305 RUSTON LNTELEPHONE:
(661) 473-2345
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 2CENSUS: 2DATE:
06/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:11 PM
MET WITH:Administrator, Jessica DelgadoTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Darius Williams conducted an unannounced Annual Inspection visit. LPA Williams met with Administrator, Jessica Delgado and discussed the purpose of the visit. Two clients were home.

The tour began in the living room. The living room was clean, in good repair, and had seating available for both clients. The dining room was attached to the living room, which also had seating available for all clients.

The kitchen was clean, in good repair, and free of odor. There was food in the refrigerator and freezer and two weeks of non-perishable food in the pantry. Water temperature reflected approximately 113.5 degrees Fahrenheit (F). Refrigerator and freezer temperature reflected approximately 42 degrees F and 1 degrees F, respectively.

Both bedrooms had bed (with required linens), chair, dresser, and working light.

Two bathrooms were observed to be clean and free of odor. Grab bars and non-slip mats were provided as needed.

Medication and chemicals were observed locked and inaccessible to clients.

Carbon monoxide and smoke detectors were present and operational.

The backyard has seating and shade available for clients. The area was free of obstructions and no pool is on the premises.

*Continued on LIC 809-C*
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME: SAILS I
FACILITY NUMBER: 157203994
VISIT DATE: 06/08/2023
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LPA Williams reviewed 2 client files and 2 staff files, which all had required documentation.

No deficiencies were cited during this visit.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
LIC809 (FAS) - (06/04)
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