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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206261
Report Date: 11/13/2024
Date Signed: 11/13/2024 11:15:05 AM

Document Has Been Signed on 11/13/2024 11:15 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: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: 2DATE:
11/13/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:55 AM
MET WITH:Jessica DelgadilloTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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Licensing Program Analyst (LPA) Katie Brown arrived unannounced to conduct a Case Management visit. LPA introduced self and explained the reason for the visit with Administrator (AD) Jessica Delgadillo.

The purpose of this visit is to verify that Staff (S1) is not on the property. Per AD, S1 does not work at the facility. AD understands that S1 is Excluded and not permitted to be on the grounds at any time.

LPA confirmed that S1 was disassociated on 9/15/2024.

There were no citations issued. An exit interview was conducted and a copy of this report was left with AD, whose signature confirms receipt.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Katie Brown
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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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