<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209062
Report Date: 07/13/2023
Date Signed: 07/13/2023 11:34:00 AM

Document Has Been Signed on 07/13/2023 11:34 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:WAY MAKER HOME CARE INC.FACILITY NUMBER:
157209062
ADMINISTRATOR:OGLETREE, WINIGELDA B.FACILITY TYPE:
735
ADDRESS:5800 WINTER RIDGE DR.TELEPHONE:
(661) 900-0149
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 6CENSUS: 3DATE:
07/13/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:02 AM
MET WITH: Administrator Winigelda OgletreeTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
 During the course of a complaint investigation Licensing Program Analyst (LPA) Shawna Doucette observed additional deficiencies. LPA met with Administrator Winigelda Ogletree.

During the tour of the facility, LPA observed R1 to have full bed rails. After records review and interviews Administrator did not have a physicians note for R1 to have full bed rails.

Refer to 809D


An exit interview was conducted with Administrator Winigelda Ogletree and a copy of this report with plans of correction and appeal rights were provided.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/13/2023 11:34 AM - It Cannot Be Edited


Created By: Shawna Doucette On 07/13/2023 at 11:06 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: WAY MAKER HOME CARE INC.
FACILITY NUMBER: 157209062

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/14/2023
Section Cited
CCR
80072(E)1.

1
2
3
4
5
6
7

80072 Personal Rights (E) Under no circumstances shall postural supports include tying of, or depriving or limiting the use of, a client's hands or feet. 1. A bed rail that extends from the head half the length of the bed and used only for assistance with mobility shall be allowed
1
2
3
4
5
6
7

Plan of Correction POC Licensee agrees to obtain a doctors note or remove full bed rails for R1 by POC due date.
8
9
10
11
12
13
14
with prior licensing approval. Bed rails that extend the entire length of the bed are prohibited except for clients who are currently receiving hospice care and have a hospice care plan that specifies the need for full bed rails. This requirement was not met as evidenced by: Licensee did not have a doctor note for R1 to have full bed rails which poses and immediate health safety and/or personal rights risk to residents in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Sergiy Pidgirny
LICENSING EVALUATOR NAME:Shawna Doucette
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2