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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209257
Report Date: 01/26/2024
Date Signed: 01/26/2024 01:54:29 PM


Document Has Been Signed on 01/26/2024 01:54 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:IVY PARK AT SEVEN OAKSFACILITY NUMBER:
157209257
ADMINISTRATOR:BRADLEY, PAMELAFACILITY TYPE:
740
ADDRESS:4301 AND 4225 BUENA VISTA ROADTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:164CENSUS: 96DATE:
01/26/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Health Service Director (HSD) Annette EgglestonTIME COMPLETED:
09:55 AM
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On 01/26/24, Licensing Program Analyst (LPA) M. Yang arrived unannounced at the above facility to conduct a Plan of Correction (POC) visit for deficiency cited on 01/23/24. LPA met with Health Service Director (HSD) Annette Eggleston who stated Administrator Pamela Anderson is unavailable.

LPA toured rooms with the HSD and did not observe any cleaning chemicals, knives, and medications in room 105, 112, and 218.

No deficiencies were issued during this visit. POC observed cleared during visit.

Exit interview was conducted. Signed report on file.

SUPERVISOR'S NAME: See MouaTELEPHONE: (559) -65-7912
LICENSING EVALUATOR NAME: Mai YangTELEPHONE: 559-772-7402
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2024
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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