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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206784
Report Date: 11/13/2023
Date Signed: 11/13/2023 02:21:31 PM

Document Has Been Signed on 11/13/2023 02:21 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:PATHWAY HOMESFACILITY NUMBER:
157206784
ADMINISTRATOR:JOHNSON, JASONFACILITY TYPE:
735
ADDRESS:15923 SAN MARCO PLACETELEPHONE:
(661) 302-4825
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY: 6CENSUS: 5DATE:
11/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:38 PM
MET WITH:Facility Staff, Rebecca ConstantinoTIME COMPLETED:
02:35 PM
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On 11/13/2023, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a POC visit. LPA introduced self, stated the purpose of the visit and requested to meet with the Administrator. Facility staff contacted Assistant Administrator, Diana Diaz, LPA received verbal permission to meet with Facility Staff, Rebecca Constantino.

The purpose of this visit, is to clear deficiencies that were issued during the Annual inspection and the Annual Inspection continuation visit.

No deficiencies issued during today's visit.

Exit interview conducted. A copy of this report was discussed and provided to Facility Staff, Rebecca Constantino whose signature on this form confirms receipt of this document.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2023
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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