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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208250
Report Date: 07/12/2023
Date Signed: 07/13/2023 03:44:01 PM

Document Has Been Signed on 07/13/2023 03:44 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:NAPD CENTER FOR CREATIVE ACHIEVEMENTFACILITY NUMBER:
157208250
ADMINISTRATOR:GREEN, VICTORIAFACILITY TYPE:
775
ADDRESS:3201 BRITTAN ROADTELEPHONE:
(661) 327-0188
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 250CENSUS: 120DATE:
07/12/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Director, Cynthia Ross TIME COMPLETED:
11:18 AM
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Licensing Program Analyst Darius Willliams conducted an announced collateral visit to interview Resident 1 who resides in an Resident Care Facility for the Elderly. LPA Williams met with Director, Cynthia Ross and discussed the purpose of the visit.

LPA Williams interviewed Resident 1 and Witness 1.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2023
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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