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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209191
Report Date: 02/16/2022
Date Signed: 02/16/2022 06:21:53 PM


Document Has Been Signed on 02/16/2022 06:21 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:WESTCHESTER HOME ON SPRUCE, THEFACILITY NUMBER:
157209191
ADMINISTRATOR:KAUR, LAKHWINDERFACILITY TYPE:
740
ADDRESS:2485 SPRUCE STREETTELEPHONE:
(661) 633-1225
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY:6CENSUS: 6DATE:
02/16/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:37 AM
MET WITH:Administrator, Lakhwinder KaurTIME COMPLETED:
03:23 PM
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O 2/16/22 Licensing Program Analyst (LPA) M. Garza arrived to the facility announced to conduct the Pre licensing visit. LPA met with Licensees Manjit Chauhan and Lakhwinder Kaur who granted LPA entry into the facility. LPA was COVID screened upon entry.

Facility currently has residents in care. Pre-Licensing being completed for a change in ownership. LPA toured facility. Common rooms have adequate furnishings and lighting. All of the resident bedrooms have all the required furnishings and adequate lighting. Hot water temperature in bathrooms measured at 112.6 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Kitchen observed to have dishes, plates, utensils. Cleaning supplies are stored in a locked cabinet. Medications are locked in a medication cabinet off the dining room. First aid kit contains all the required items. A fire extinguisher is present and has a service date of 12/03/2021. Smoke alarms and carbon monoxide were both functioning at time of visit.

Outside of the facility toured. Exits open free of obstruction. Facility has delay egress on doors.

All required postings are posted or in process of being ordered. Facility phone number will be (661) 633-1225.

Component III was conducted during pre-licensing visit with Applicants.

I have found that applicant has met all pre licensing requirements. LPA will submit documentation to CAB for final review.

Due to COVID precautionary measures a copy of this report will be emailed to: GCCS2205@gmail.com. A delivered and read receipt serves as confirmation of receipt.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 650-7914
LICENSING EVALUATOR NAME: Mary GarzaTELEPHONE: (559) 365-9009
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2022
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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