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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206291
Report Date: 01/25/2023
Date Signed: 01/25/2023 12:08:32 PM

Document Has Been Signed on 01/25/2023 12:08 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:BRIDGE PROGRAM - BAKERSFIELDFACILITY NUMBER:
157206291
ADMINISTRATOR:DEANNA BROWNFACILITY TYPE:
772
ADDRESS:6744 EUCALYPTUS DRIVETELEPHONE:
(661) 363-8127
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 15CENSUS: 12DATE:
01/25/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Deanna BrownTIME COMPLETED:
12:21 PM
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Licensing Program Analyst (LPA) Melinda Medina arrived to conduct a Case Management. LPA introduced self and allowed entrance by Direct Care Staff, Program Director contacted by telephone and arrived a short time later to conduct Case Management visit. LPA met with Program Director (PD), Deanna Brown and discussed the purpose of today's visit.

The Department received an incident report, reporting that on 12/11/22, R1 left facility (AWOL) without permission. Per PD, R1 was located and stabilized and re-admitted. At time of Case Management visit it was reported that R1 left facility (AWOL) without permission for a second time on 1/16/23, located, stabilized and transferred to a higher level of care. Program Director Deanna Brown stated that during both AWOL's R1 was discovered absent from facility during 30 minute checks conducted by staff. Facility did follow AWOL protocols and contacted all responsible parties, law enforcement, and this Department.

LPA Medina reviewed R1's file and physician report (LIC 624), it is documented on R1's LIC 624 that R1 may leave facility unsupervised.

No deficiencies cited.

Exit Interview conducted with Program Director, Deanna Brown. A copy of this report provided for facility records.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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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