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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209184
Report Date: 07/17/2024
Date Signed: 07/17/2024 01:06:33 PM

Document Has Been Signed on 07/17/2024 01:06 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:AIMES PACINIFACILITY NUMBER:
157209184
ADMINISTRATOR/
DIRECTOR:
RUTLEDGE, ALEXISFACILITY TYPE:
737
ADDRESS:2700 PACINI STREETTELEPHONE:
(661) 589-9992
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY: 3CENSUS: 3DATE:
07/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Administrator, Alexis RutledgeTIME VISIT/
INSPECTION COMPLETED:
12:18 PM
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On 07/17/2024, Licensing Program Analyst (LPAs) Walton and Leffall arrived unannounced to conduct a annual inspection. LPAs introduced themselves, stated purpose of the visit, and requested to meet with the Administrator. LPAs met with Administrator, Alexis Rutledge.

LPAs conducted a tour of the facility. During the inspection the facility appeared clean and odor free and at a comfortable temperature. Common areas were furnished and had adequate seating and lighting available. Resident bedrooms appeared clean. Residents bathrooms appeared clean, water temperature measured at 113.8 degrees F. Facility kitchen appeared to be clean and safe for food preparation. Food supply was checked.

Exterior tour conducted, all exits open and free of obstructions on today’s visit. Facility swimming pool was inaccessible to residents in care surrounded by a locked fence. Fire extinguishers were last serviced on 04/29/2024 and 07/15/2024. Last fire drill conducted on 06/11/2024. Cleaning supplies observed to be locked in a cabinet in the garage. LPA reviewed client and staff files. Medications observed to be administered as prescribed and inaccessible to clients in care.

No deficiencies issued during today's inspection.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Alexis Rutledge, whose signature on this form confirm receipt of this document.

LPAs are requesting the following documents be submitted to the Fresno CCL office by 07/31/2024: Current copy of Administrator Certificate, Designation of Facility Responsibility, Administrator Organization, Affidavit regarding Client/Resident Cash Resources, Emergency and Disaster, Plan Personnel Report, Register of Facility Clients/Residents, Surety Bond.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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