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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206642
Report Date: 06/19/2023
Date Signed: 06/19/2023 11:53:20 AM

Document Has Been Signed on 06/19/2023 11:53 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:NANKIL ENTERPRISES INC. DBA HARMONY SPRINGSFACILITY NUMBER:
157206642
ADMINISTRATOR:NANKIL, PATRICKFACILITY TYPE:
735
ADDRESS:12006 KENSETH STREETTELEPHONE:
(661) 679-6537
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 4CENSUS: 4DATE:
06/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Patrick NankilTIME COMPLETED:
12:05 PM
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On 6/19/203, Licensing Program Analysts (LPAs) M. Medina conducted an unannounced Annual Required Inspection. LPA Medina introduced self and allowed entrance by Direct Care Staff, Patrick Nankil contacted by telephone and he arrived a short time later to conduct inspection.

Currently, 4 residents are in placement. All residents were present at time of inspection.

Facility tour conducted with Direct Care Staff. Facility observed to be well lit, clean and odor free. All common areas have adequate seating available. Resident bedrooms toured, all bedrooms observed to have required furnishings. Bathrooms toured, showers observed to have non-slid mats and grab bars. Water temperature during facility inspection measured at 108 degrees F. Kitchen toured, all sharps observed to be locked and secured in pantry. Facility observed to have a 2-day supply of perishable and 7-day of non-perishable available. Medication observed to be locked and secured in medication cabinet and observed to be administered as ordered. Smoke detectors and carbon monoxide detector observed operational during inspection. Fire extinguisher present with a purchase date of 10/04/22.

Outside of facility toured. All exits open free of obstruction. Perimeter of back yard is secured with a fence and free of obstruction.

Exit interview conducted. No deficiencies cited.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2023
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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