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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206261
Report Date: 07/20/2024
Date Signed: 07/20/2024 01:37:38 PM

Document Has Been Signed on 07/20/2024 01:37 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 XFACILITY NUMBER:
157206261
ADMINISTRATOR/
DIRECTOR:
TUCKER, JACQUELINEFACILITY TYPE:
735
ADDRESS:7617 INDIAN GULCH STTELEPHONE:
(661) 473-2333
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 5CENSUS: 4DATE:
07/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Administrator Jessica DelgadilloTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Jessica Delgadillo. LPA disclosed the purpose of the inspection and was granted entry into the facility by Staff.

A tour of the facility was conducted with the Administrator. The residence was set at 75 F temperature and free of passageway obstructions inside and outside.

LPA Doucette observed 5 bedrooms in the residence. Residents' rooms were toured and inspected. Rooms were found to be clean. Hot water temperature was measured 105.2 F.

Kitchen toured, supply of food observed and food stored properly for perishable and nonperishable. Knives were stored in a locked closet. Medications were stored in a locked Medication closet. Cleaning supplies were in a locked cabinet. Smoke detectors and carbon monoxide detectors were checked and operating. Fire extinguishers were charged and had service dates of 3/28/24. Fire drill was last completed on 07/8/24. Facility has a pull station fire alarm.

LPA observed a self latching gate on the outside of the residence. There was outdoor seating for the residents. Facility has a pool that is gated and locked to be made inaccessible to residents in care. Staff have water safety training.

Resident, medication and staff records were reviewed and found to be complete. Current first aid and CPR were on file for staff. Clients were on an outing during visit.

An exit interview was conducted with the Administrator and a copy of this report was provided.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2024
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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