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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206591
Report Date: 11/29/2023
Date Signed: 11/29/2023 01:19:36 PM


Document Has Been Signed on 11/29/2023 01:19 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: 4DATE:
11/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Jerry YatcoTIME COMPLETED:
01:35 PM
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On 11/29/2023, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self, stated purpose of visit, and allowed entrance by Licensee, Jerry Yatco. Jasmin Yatco serves as facility Adminstrator #6016639740, expires 5/23/2024.

There are currently four (4) residents in care. All residents were present during today's inspection. Residents were observed to be engaging in activities at the dining room today with the Activities Coordinator during inspection.

Facility tour conducted with licensee. Facility has 5 bedrooms, 4 private rooms and one shared double room. Facility observed to be in good repair, well lit, have adequate seating in all common areas, comfortable temperature, and to be odor free. All resident bedrooms observed to be fully furnished. 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 in bathroom at 110 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. Laundry room is also locked, secured, and inaccessible to residents. Medications observed to be locked and secured in hallway cabinet.

Fire extinguisher present with a purchase date of 1/04/2022. Carbon monoxide detector and smoke detector observed operational during inspection. Facility is also equipped with a pull station. Last fire drill conducted on 11/07/23 according to facility records.

Outside of facility toured. No obstructions or hazards observed.

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: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023
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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