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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206771
Report Date: 06/11/2024
Date Signed: 06/11/2024 02:09:49 PM

Document Has Been Signed on 06/11/2024 02:09 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 APPLETREEFACILITY NUMBER:
157206771
ADMINISTRATOR/
DIRECTOR:
JACQUELINE D. TUCKERFACILITY TYPE:
735
ADDRESS:11611 SAN MINIATO AVETELEPHONE:
(661) 570-3035
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 5CENSUS: 4DATE:
06/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Jacqueline TuckerTIME VISIT/
INSPECTION COMPLETED:
02:31 PM
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On 6/11/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA arrived, contacted Administrator by telephone who arrived a short time later to conduct facility inspection.

Facility currently has four (4) residents in care. All residents were at day program at time of inspection. Residents attend day program Monday through Friday 8:30 AM - 3:30 PM.

Facility tour conducted with Administrator both inside and outside. Facility observed to be clean, odor free, and a comfortable temperature. Resident bedrooms toured, all resident rooms observed to have required accommodations. Resident bathrooms toured, all fixtures observed to be operational during time of inspection. Water temperature measured at 108 degrees F. Kitchen toured, facility observed to have a 7-day supply of non-perishable food and a 2-day supply of perishable food. All sharps observed to be locked and secured in garage and inaccessible to residents. Living room and dining room observed to have adequate seating for all residents. All chemicals and detergents observed to be locked and secured in locked cabinet in garage.

Outside of facility tour, all exits open free of obstruction. Side gate observed to be self latching. Seating available for residents under covered patio.

Facility observed to have a pull station in the living room area. Smoke detectors and carbon monoxide detectors present and observed operational during today's inspection. Fire extinguisher present with a date of service 3/28/24. Last fire drill conducted on 6/06/2024 according to facility records.

Resident and staff files reviewed. Staff interviewed.

No deficiencies cited during inspection.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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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