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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208935
Report Date: 08/07/2024
Date Signed: 08/07/2024 01:20:37 PM

Document Has Been Signed on 08/07/2024 01:20 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:TRIUMPH IN THE WESTFACILITY NUMBER:
157208935
ADMINISTRATOR/
DIRECTOR:		CHAVEZ, CARLOSFACILITY TYPE:
737
ADDRESS:8130 NORRIS RDTELEPHONE:
(661) 218-9711
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 4CENSUS: 4DATE:
08/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Carlos Chavez, Jill Bevins,
Agustin Aguilera		TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 8/07/24, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA arrived, stated purpose of visit and allowed entrance. LPA met with Agustin Aguilera, Assistant Administrator to conduct facility tour. Also present was Carlos Chavez, Administrator and Jill Bevins, Program Liaison and Assurance Development Coordinator.

Facility currently has four (4) residents in care. All residents were present at start of facility inspection, then went into community to participate in a fitness program.

Facility tour conducted both inside and outside. Facility observed to be clean, odor free, and a comfortable temperature. Resident bedrooms toured, all resident rooms observed to have required accommodations. Resident bathrooms toured, all fixtures observed to be operational during time of inspection. Water temperature measured at 117 degrees F. Kitchen toured, facility observed to have a 7-day supply of non-perishable food and a 2-day supply of perishable food. All sharps observed to be locked and secured inside of a safe that is placed in a locked kitchen cabinet. Living room and dining room observed to have adequate seating for all residents. All chemicals and detergents observed to be locked and secured in locked cabinet in garage. First Aid kit present and secured in closet with resident toiletries

Outside of facility tour, all exits open free of obstruction. Pool is surrounded by a wrought iron fence that is approximately 15 feet tall and observed to be locked and secured. Staff files reviewed include water safety training. Side gate near swimming pool area is equipped with delayed egress and observed operational. Facility has large covered patio area with seating for all residents.

Facility observed to have a pull station near front door and is equipped with sprinkler system. Smoke detectors and carbon monoxide detectors present and observed operational during today's inspection. Fire extinguisher present with a date of service 11/7/2023. Last fire drill conducted on 806/2024 according to facility records.

Resident and staff files reviewed. Staff interviewed.

No deficiencies cited during inspection.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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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