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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206652
Report Date: 06/10/2022
Date Signed: 06/10/2022 10:46:11 AM


Document Has Been Signed on 06/10/2022 10:46 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: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: DATE:
06/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Administrator Myrna Albandia TIME COMPLETED:
11:00 AM
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On 6/10/2022, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an Annual
Inspection - Infection Control. LPA introduced self, stated the purpose of the visit, and met with Administrator
Myrna Albandia. Administrator states she is closing down the facility and has submitted paperwork to CCLD Office.

LPA conducted a final inspection with Administrator and confirmed that there are no residents in the facility. LPA obtained the original License. Closure inspection is complete.

No deficiencies issued.

An exit interview was conducted with Administrator. Report signed on-site by Administrator and printed copy provided. Facility closure will be processed upon LPA’s return to the office.
SUPERVISOR'S NAME: See MouaTELEPHONE: (559) 580-4596
LICENSING EVALUATOR NAME: Kamaldeep KaurTELEPHONE: (559) 341-7449
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2022
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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