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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157204153
Report Date: 06/09/2023
Date Signed: 06/09/2023 12:32:09 PM

Document Has Been Signed on 06/09/2023 12:32 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:PATHPOINTFACILITY NUMBER:
157204153
ADMINISTRATOR:WHITE, SHAWNFACILITY TYPE:
775
ADDRESS:4701 STOCKDALE HWYTELEPHONE:
(661) 617-6170
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 60CENSUS: 44DATE:
06/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Administrator, Shawn White
Program Coordinator, Joy Bower		TIME COMPLETED:
12:04 PM
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Licensing Program Analyst (LPA) Darius Williams conducted an unannounced Annual Inspection visit. LPA Williams met with Administrator, Shawn White and Program Coordinator, Joy Bower, and discussed the purpose of the visit.

The tour began in the main lobby, which was clean and free of odor.

LPA Williams toured suite A and observed clients actively engaging in various arts and crafts with staff in the community area. The temperature reflected approximately 75 degrees via facility thermostat.

There is a kitchen on site but no meals are provided. Clients bring their own lunches to the day program and a microwave and refrigerator is provided for storage if needed.

LPA observed storage for clients belongings and a designated room from clients to have personal space, which the facility identified as the sentry room. Bathrooms were clean and had grab bars available for clients.
Smoke detectors, carbon monoxide, fire extinguishers, and first aid kits were present and operational.

Chemicals were observed locked and inaccessible to clients. Facility does not centrally store medication.

LPA Williams reviewed 4 staff files and 5 clients files, which all had required documentation.

No deficiencies were observed during the 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: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2023
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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