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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206652
Report Date: 06/22/2021
Date Signed: 06/23/2021 01:47:35 PM

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:24/7 RESIDENTIAL CARE HOMEFACILITY NUMBER:
157206652
ADMINISTRATOR:MYRNA ALBANDIAFACILITY TYPE:
740
ADDRESS:612 JUMBUCK LANETELEPHONE:
(661) 398-9394
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:6CENSUS: 0DATE:
06/22/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:37 AM
MET WITH:Licensee Myrna AlbandiaTIME COMPLETED:
12:00 PM
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Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Licensee Myrna Albandia and discussed the purpose of the visit. Licensee Myrna and LPA began the tour at the front entrance of the facility.

Facility currently does not have any residents in care. Licensee has a completed and approved mitigation plan.

Cleaning supplies were observed behind a locked cabinet in laundry room. LPA observed the following personal protective equipment in a storage cabinet; hand sanitizer, gown, face shield, gloves, and masks. Licensee will complete training for staff prior to admitting a resident. All staff are vaccinated.

No deficiencies were observed.

Exit interview was conducted and a copy of this report was provided.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
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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