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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206743
Report Date: 06/21/2022
Date Signed: 06/21/2022 12:30:25 PM


Document Has Been Signed on 06/21/2022 12:30 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 GARDENS RESIDENTIAL CARE IIFACILITY NUMBER:
157206743
ADMINISTRATOR:RODELIO L. ROURAFACILITY TYPE:
740
ADDRESS:10813 DELICATO CTTELEPHONE:
(661) 410-8022
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:6CENSUS: 4DATE:
06/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:41 AM
MET WITH:Olivia RouraTIME COMPLETED:
12:12 PM
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On 6/21/2022, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Infection Control Inspection. LPA introduced self, stated purpose of visit and allowed entrance by Direct Care Staff. Administrator, Olivia Roura contacted by telephone and arrived a short time later. COVID-19 guidelines are in place. Visitor log-in/temperature check was observed upon entry. Facility has one entrance/exit point, all staff and visitors enter through front door.

Facility inspection conducted with Direct Care Staff. Facility appeared clean with no obstruction or fire clearance issues. Social distancing is maintained in the common and dining areas. Bathrooms have trash cans with lid. Resident bedrooms toured, all resident bedrooms have private bedrooms.

Fire extinguisher present and has a service date of 05/26/2022. Carbon monoxide detector present and observed to be operational during today's inspection. Water temperature measured at 114 degrees F.

LPA observed residents’ medications to be locked and secured in hallway cabinet. Food supply observed to be adequate for residents. Staff records were reviewed for good health and infection control training. Facility staff was observed with mask on. Rodelio Roura serves as facility Administrator certification #6027980740, expires 9/04/23.

LPA received copy of Administrator Certificate during inspection. Administrator to submit copies of LIC 500, LIC 610, LIC 9020 to Fresno CCL office no later than 7/01/22.

No deficiencies were observed. Exit interview was conducted. A copy of this report was left for facility file.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2022
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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