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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209217
Report Date: 08/10/2022
Date Signed: 08/10/2022 11:56:24 AM

Document Has Been Signed on 08/10/2022 11:56 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:PATHWAY HOMESFACILITY NUMBER:
157209217
ADMINISTRATOR:JOHNSON, JAIMYFACILITY TYPE:
740
ADDRESS:334 MONTCLAIR STTELEPHONE:
(661) 972-6051
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 0DATE:
08/10/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:51 AM
MET WITH:Jaimy Johnson, Administrator
Jason Johnson, Licensee		TIME COMPLETED:
12:15 PM
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On 8/10/22 at 10:51 AM, Licensing Program Analyst (LPA) Malia Thao arrived announced to conduct an announced prelicensing inspection. LPA met with Administrator Jaimy Johnson and Licensee Jason Johnson, and granted entry.

LPA conducted tour of inside and outside of the facility. No obstructions observed. All bedrooms have sufficient furniture and lighting. One grab bar observed for use of toilet and shower in both hallway and master bathrooms. Non-skid strips observed for both showers. Facility set at comfortable temperature. Fire extinguisher was purchased on 2/5/22. Dishware and utensils observed. Centrally stored medication observed designated to locked hall closet. First aid kit observed complete. Hot water measured at 105.1 degrees F in the hallway bathroom. No fire clearance issues. Chemicals and cleaning solutions observed inaccessible to cabinet under kitchen sink. Administrator certificate is valid. Telephone service is active. Facility telephone number is: 661-735-7948.

Comp III completed. All licensing requirements have been met. LPA will notify CAB analyst of completion. CAB will finalize application and submit license to Licensee once the application process has been completed.

Exit interview conducted. A copy of this report was given to Administrator Jaimy Johnson, whose signature confirms receipt of this report.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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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