<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206891
Report Date: 08/16/2022
Date Signed: 08/16/2022 08:21:47 PM


Document Has Been Signed on 08/16/2022 08:21 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:VILLAGE AT SEVEN OAKS ASSISTED LIVING, THEFACILITY NUMBER:
157206891
ADMINISTRATOR:OSORIO, JULIUSFACILITY TYPE:
740
ADDRESS:4301 BUENA VISTA RDTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:128CENSUS: 75DATE:
08/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:29 AM
MET WITH:Krystal Jenkins, Regional Executive Director SpecialistTIME COMPLETED:
08:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 8/16/22, Licensing Program Analysts (LPAs) M. Medina and L. Salazar arrived at the facility unannounced to conduct an Annual Required Inspection. LPAs met with Krystal Jenkins, Regional Executive Director Specialist and stated purpose of visit. All COVID screening and sign in completed upon entry.

Krystal Jenkins is serving as Intermin Administrator, Certificate #6045295740, expires 10/08/2023.

Facility consists of Assisted Living and Memory Care Unit. LPA Medina toured Memory Care portion of facility. LPA observed residents in areas of the facility watching television, engaging in social hour in activity room, and some relaxing in their bedrooms. LPA observed pull cords in resident bedrooms. LPA observed all exits in Memory Care to have a 30-second delay egress. Facility is equipped with pull stations and fire sprinklers throughout facility. Fire extinguisher present with a service date of 9/12/2021.

LPA Medina conducted Infection Control and staff portion of Inspection tool. LPA will require a follow up visit to complete inspection. Facility resident and staff files reviewed during inspection.

LPA Salazar will document additional information on a Case Management report.

Due to time restraints this inspection will need to be continued at a later time and any deficiencies if observed will be issued during follow up inspection.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1