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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206291
Report Date: 08/14/2024
Date Signed: 08/15/2024 09:00:19 AM

Document Has Been Signed on 08/15/2024 09:00 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:BRIDGE PROGRAM - BAKERSFIELDFACILITY NUMBER:
157206291
ADMINISTRATOR/
DIRECTOR:
DEANNA BROWNFACILITY TYPE:
772
ADDRESS:6744 EUCALYPTUS DRIVETELEPHONE:
(661) 363-8127
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 15CENSUS: 13DATE:
08/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:42 AM
MET WITH:Administrator Deanna BrownTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analysts (LPA)'s Shawna Doucette and Sarah Hurtarrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Deanna Brown. LPA's disclosed the purpose of the inspection and was granted entry into the facility by the Administrator.

A tour of the facility was conducted with Lead Recovery Coach Celeste Elison. The facility was free of passageway obstructions inside and outside.

LPA Doucette observed 8 bedrooms in the facility. Residents' rooms were toured and inspected. Rooms were found to be clean. Hot water temperature was unable to be measured in resident bathroom 112.8 F.

Kitchen toured, supply of food observed and food stored properly. Knives were stored in a locked in a storage room. Medications were stored in a locked Medication room. Cleaning supplies were in a locked in staff bathroom. Smoke detectors and carbon monoxide detectors were checked. Facility is hard wired with pull station alarms and sprinkler system. Fire extinguishers were charged and had service dates of 7/26/24. Fire drill was last completed on 05/20/24.

There was outdoor seating for the residents.

Staff records were reviewed. Resident records were reviewed and medications. Current first aid and CPR were on file for staff.

An exit interview was conducted with the Administrator. A copy of this report was discussed and plans of correction and appeal rights were left with the Administrator, Deanna Brown, whose signature on this form confirm receipt of these documents.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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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Document Has Been Signed on 08/15/2024 09:00 AM - It Cannot Be Edited


Created By: Shawna Doucette On 08/14/2024 at 02:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: BRIDGE PROGRAM - BAKERSFIELD

FACILITY NUMBER: 157206291

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 08/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
81087(l)
Buildings and Grounds
(l) The licensee shall ensure that items which could pose a danger if readily available to clients, including but not limited to disinfectants, cleaning solutions and poisons are stored where inaccessible to clients.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) , the licensee did not comply with the section cited above in a tool shed with sharps/saws was left unlocked which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2024
Plan of Correction
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Licensee agrees to lock tool shed by POC due date 8/15/24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Sergiy Pidgirny
LICENSING EVALUATOR NAME:Shawna Doucette
LICENSING EVALUATOR SIGNATURE:
DATE: 08/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/14/2024


LIC809 (FAS) - (06/04)
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