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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208251
Report Date: 08/18/2021
Date Signed: 08/20/2021 11:47:07 AM

Document Has Been Signed on 08/20/2021 11:47 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:FREISE HOPE HOUSEFACILITY NUMBER:
157208251
ADMINISTRATOR:OLLIVIER, REBECCA AFACILITY TYPE:
772
ADDRESS:721 8TH STTELEPHONE:
(661) 326-9700
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY: 14CENSUS: 9DATE:
08/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Administrator Ronald Cordy and Administrator Guy HossTIME COMPLETED:
12:30 PM
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Licensing Program Analyst LPA Shawna Doucette conducted an Annual Inspection on this date. LPA was met by Administrator Ronald Cordy and Administrator Guy Hoss and discussed the purpose of the visit Administrator Ronald Cordy and Administrator Guy Hoss responded to the facility to conduct the visit with LPA and began the tour at the front entrance of the facility.

Visitor log-in/temperature check, masks, and disinfection station was observed upon entry. Facility has one entrance/exit point. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common areas. Hand washing and other various Covid-19 related signs were observed in the common areas.

LPA observed a two day supply of perishable food and seven day supply of non-perishable food. Cleaning supplies were observed behind a locked in the the laundry room. LPA observed the following personal protective equipment in a storage cabinet; hand sanitizer, face shield, gloves, and masks. Resident’s files have updated emergency contact information.

Facility will submit current administrator paperwork. No deficiencies were observed.

Exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2021
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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