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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208773
Report Date: 09/13/2023
Date Signed: 09/13/2023 02:29:57 PM


Document Has Been Signed on 09/13/2023 02:29 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: 76DATE:
09/13/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:21 PM
MET WITH:Licensee Representative Virginia Garcia and Administrator Ramona ElecoTIME COMPLETED:
02:30 PM
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An informal meeting was held on 09/13/2023 at the Fresno Regional Office. The purpose of the informal meeting was to discuss recently identified issues/concerns associated with the operation of the facility. The informal meeting process was explained during this meeting.

The following were in attendance:
Virginia Garcia, Licensee Representative
Ramona Eleco, Administrator
Sergiy Pidgirny, Licensing Program Manager
Shawna Doucette, Licensing Program Analyst
Lisett Padgett, Licensing Program Analyst

Licensee agrees to submit a plan of resolution of the issues listed to Licensing by 09/29/23.
The following concerns were addressed:
Responsibility of Licensing Governing Body, Administrator Qualifications and Duties, Care and Supervision, Medications, and Reporting Requirements.
TSP was offered to Licensee.
Licensee was provided with copies of all applicable regulations and/or Health and Safety Code and a copy of this report.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 246-0610
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:
DATE: 09/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/13/2023
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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