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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209192
Report Date: 02/15/2022
Date Signed: 02/16/2022 10:56:50 AM


Document Has Been Signed on 02/16/2022 10:56 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:BRIGHTON MANORFACILITY NUMBER:
157209192
ADMINISTRATOR:KAUR, LAKHWINDERFACILITY TYPE:
740
ADDRESS:305 ALUM BAY COURTTELEPHONE:
(661) 589-1500
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:6CENSUS: 5DATE:
02/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator Lakhwinder Kaur and Licensee Mangit ChauhanTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Shawna Doucette arrived to the facility announced to conduct the Pre licensing visit. LPA Shawna Doucette met with Licensee/Administrator Administrator Lakhwinder Kaur and Licensee Mangit Chauhan who granted LPA's entry into the facility. Facility is change of ownership and is operating with residents in care.

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 113.7 degrees F. LPA observed a supply of extra bed linens and personal hygiene and grooming products. Bathrooms have skid mats and grab bars. LPA observed a two day perishable and 7 day non perishable food supply. Kitchen observed to have dishes, plates, utensils ect.

Cleaning supplies are stored in a locking cabinet in the garage. Medications are locked in a medication closet. First aid kit contains all the required items. A fire extinguisher is present and has a service date of 12/03/2021. Smoke detectors and carbon monoxide were operating.

Outside of the facility toured. Exits open free of obstruction. The residence has a delay egress which sounds the indoor alarm. No outside hazards were observed. No pools or bodies of water. Facility has a pull station fire alarm.

All required postings are posted. Facility phone number will be (661) 589-1500.
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 in Sacramento for final review prior to license being issued.
SUPERVISOR'S NAME: Sergiy PidgirnyTELEPHONE: (559) 650-7923
LICENSING EVALUATOR NAME: Shawna DoucetteTELEPHONE: (559) 580-4595
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2022
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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