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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208773
Report Date: 05/26/2022
Date Signed: 05/26/2022 09:35:19 PM


Document Has Been Signed on 05/26/2022 09:35 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:JASMIN TERRACE AT BAKERSFIELDFACILITY NUMBER:
157208773
ADMINISTRATOR:ELECO, RAMONA D.FACILITY TYPE:
740
ADDRESS:5400 STINE ROADTELEPHONE:
(661) 398-8802
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:99CENSUS: 77DATE:
05/26/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
07:45 PM
MET WITH:Administrator (Admin) Ramona Eleco; TIME COMPLETED:
09:45 PM
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A Case management visit was conducted on the date & during the times incidated above by Licensing Program Analyst (LPA) K. Mcclurg. LPA met with Administrator (Admin) Ramona Eleco. Purpose of this visit was to verify that former staff (S1) is no longer working &/or on the premises of this facility.

According to Admin, S1 only worked at this location for a very short time in 2020. S1 does not work at this facility & is not on the premises of this facility. Licensee provided written statement that S1 is no longer an employee & is not on facility premises.

Exit interview conducted with Admin. Report provided.
SUPERVISOR'S NAME: Andy XiongTELEPHONE: (559) 650-7904
LICENSING EVALUATOR NAME: Kelly J. McClurgTELEPHONE: (559) 246-0435
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2022
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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