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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206769
Report Date: 07/07/2022
Date Signed: 07/07/2022 02:50:53 PM

Document Has Been Signed on 07/07/2022 02:50 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:SAILS RANCHOFACILITY NUMBER:
157206769
ADMINISTRATOR:MARQUEZ, BERTAFACILITY TYPE:
735
ADDRESS:4644 WYATT STTELEPHONE:
(760) 547-7626
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 4CENSUS: 4DATE:
07/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:09 PM
MET WITH:Berta Marquez, AdministratorTIME COMPLETED:
03:00 PM
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On 07/7/2021, Licensing Program Analyst (LPA) K.Kaur arrived unannounced to conduct an Annual Inspection. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. LPA met with Administrator, Berta Marquez.

Facility has one central entry/exit. LPA observed a visitor log-in/screening at the entry. LPA observed signs promoting social distancing, cough/sneeze etiquette, handwashing throughout the facility.

LPA observed a 30-day supply of PPE and cleaning supplies located in the Garage. LPA checked the facility food supply. LPA observed a 7-day supply of non-perishable foods and a 2- day supply of perishable foods. Fire extinguisher in kitchen last serviced on 4/22/2022 and was fully charged. All pathways, entrances and exits were clear from obstructions. No fire clearance issues observed during this inspection. Bathrooms observed to be stocked with paper towels, liquid soap, Trash bins with lids, and hand washing signs.

LPA observed a 30-day supply of medications. Medications were observed to be locked and inaccessible to residents in care. Staff records were reviewed for good health and infection control training. Facility staff was observed with mask on. Residents wear masks when away from the community. Resident’s files have updated emergency contact information. No deficiencies issued during this inspection.

LPA is requesting the following documents be submitted to the Fresno CCL office by 7/14/2022: Current copy
of Administrator Certificate, Designation of Facility Responsibility (LIC308), Administrator Organization
(LIC309), Affidavit regarding Client/Resident Cash Resources (LIC 400), Emergency and Disaster Plan
(LIC610D), Personnel Report (LIC500), Register of Facility Clients/Residents for LIC9020.

An exit interview was conducted with Administrator. Report signed on-site by Administrator and printed copy
provided.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Kamaldeep Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2022
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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