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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157206891
Report Date: 10/31/2022
Date Signed: 10/31/2022 11:12:28 AM


Document Has Been Signed on 10/31/2022 11:12 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:VILLAGE AT SEVEN OAKS ASSISTED LIVING, THEFACILITY NUMBER:
157206891
ADMINISTRATOR:JENKINS, KRYSTALFACILITY TYPE:
740
ADDRESS:4301 BUENA VISTA RDTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:128CENSUS: 76DATE:
10/31/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Pamela Bradley, Exectuive Director and Annette Eggleston, Health Service DirectorTIME COMPLETED:
11:18 AM
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On 10/31/22, Licensing Program Analyst (LPA) M. Yang arrived at the facility unannounced to conduct a case management visit based on record review of incident report submitted. LPA was greeted by Pamela Bradley, Executive Director, stated the purpose of the visit and was allowed entry into the facility.

The purpose of today's visit is to follow up on case management visit which was conducted on 10/24/22.



LPA interviewed Executive Director. Written incident report was discussed with Executive Director,

No deficiencies issued during today's inspection.

An exit interview conducted. A copy of this report was discussed and provided to the Executive Director.

SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3274
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2022
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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