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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208893
Report Date: 10/17/2023
Date Signed: 10/17/2023 01:50:11 PM

Document Has Been Signed on 10/17/2023 01:50 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:SAILS VIIFACILITY NUMBER:
157208893
ADMINISTRATOR:MARQUEZ, JOSEFACILITY TYPE:
735
ADDRESS:4013 REDFORD CTTELEPHONE:
(661) 473-2339
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 4CENSUS: 4DATE:
10/17/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Administrator Jose MarquezTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility to conduct a case management inspection regarding an attempted AWOL that occurred on 09/14/23. LPA met with Administrator Jose Marquez.

During the course of the Case Management investigation, LPA reviewed C1's file/IPP and interviewed staff.


No deficiencies observed.

A copy of this report was provided to the Administrator.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2023
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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