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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206591
Report Date: 10/15/2024
Date Signed: 10/15/2024 02:12:41 PM


Document Has Been Signed on 10/15/2024 02:12 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:ARCADIA FAMILY CAREFACILITY NUMBER:
157206591
ADMINISTRATOR:YATCO, JERRYFACILITY TYPE:
740
ADDRESS:8306 SHIPROCK DRIVETELEPHONE:
(661) 587-0370
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:6CENSUS: 6DATE:
10/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:03 AM
MET WITH:Jerry Yatco
Jasmin Yatco		TIME COMPLETED:
02:25 PM
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On 10/15/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self, stated purpose of visit, and allowed entrance by Direct Care Staff. Licensees contacted by telephone and arrived a short time later to conduct inspection.

There are currently six (6) residents in care. All residents were present during today's inspection. Residents were observed to be relaxing in the living room, relaxing and listening to music. Facility observed to be clean, well lit, and a comfortable temperature. Facility tour conducted with Administrator, Jerry Yatco. Facility tour began in resident bedrooms, facility has 1 shared room and 4 private bedrooms. Resident bathrooms toured, showers observed to have shower chairs, grab bars, and non-skid mats available. Toilet area also observed to have grab bars. Water temperature measured at 111 degrees F. Kitchen toured, facility observed to have adequate food supply for residents in care. All knobs observed off the stove, and sharps observed to be locked and secured in kitchen drawer. Cleaning supplies under sink are locked, secured, and inaccessible to residents, with additional supplies observed secured in garage. . Laundry room is also locked, secured, and inaccessible to residents. Medications observed to be locked and secured in hallway cabinet. All medications observed to have original labels and to be administered as prescribed.

Fire extinguisher present with a purchase date of 1/17/2024. Carbon monoxide detector and smoke detector observed operational during inspection. Last fire drill conducted on 9/01/2024 according to facility records.

Outside of facility toured. Exit gate observed to be self-latching and free from obstruction. No hazards observed.

LPA received copy of updated LIC 9020 (Register of Facility Clients/Residents) and liability insurance during inspection.

No deficiencies observed during inspection.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2024
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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