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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206776
Report Date: 03/07/2024
Date Signed: 03/07/2024 09:12:02 AM

Document Has Been Signed on 03/07/2024 09:12 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:EUCALYPTUS HOUSEFACILITY NUMBER:
157206776
ADMINISTRATOR:GREENHALGH, STELLAFACILITY TYPE:
735
ADDRESS:7708 SPROAT WAYTELEPHONE:
(661) 282-5687
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 5CENSUS: 3DATE:
03/07/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Administrator, MIsty VeaseyTIME COMPLETED:
09:11 AM
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Licensing Program Analyst (LPA) Darius Williams conducted a Case Management visit. LPA Williams met with Administrator, Misty Veasey and discussed the purpose of the visit.

According to the Departments FAS record system, Stella Greenhalgh is the Administrator. LPA has worked with Administrator Misty Veasey at the facility who reported being the Administrator for the Eucalyptus facility. LPA informed Misty that a Administrator Change packet is required to be submitted to the Department to identify her as the Administrator.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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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