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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206770
Report Date: 07/31/2023
Date Signed: 07/31/2023 03:18:20 PM


Document Has Been Signed on 07/31/2023 03:18 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:POINTE AT SUMMIT HILLS, THEFACILITY NUMBER:
157206770
ADMINISTRATOR:BENNY FARILLASFACILITY TYPE:
740
ADDRESS:4501 UPLAND POINT DRIVETELEPHONE:
(661) 447-4800
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:102CENSUS: 60DATE:
07/31/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Dr. David Dougherty, Licensee RepresentativeTIME COMPLETED:
03:30 PM
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An informal meeting was held on 07/31/2023 at the Fresno Regional Office. The purpose of the informal meeting was to discuss recently identified issues/concerns associated with the operation of the facility. The informal meeting process was explained during this meeting.

The following were in attendance:
Dr. David Dougherty, Licensee Representative
Nicole Scott, Regional Director
Griselda Ramirez, Staff
Sheree Addison, Staff
Sergiy Pidgirny, Licensing Program Manager
Shawna Doucette, Licensing Program Analyst

The following concerns were addressed:
Responsibility of Licensing Governing Body, Administrator Qualifications and Duties,Care and Supervision, Medications, and Reporting Requirements.

Licensee was provided with copies of all applicable regulations and/or Health and Safety Code and a copy of this report.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2023
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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