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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209278
Report Date: 05/23/2024
Date Signed: 05/23/2024 11:41:01 AM

Document Has Been Signed on 05/23/2024 11:41 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:GLORY IN THE WESTFACILITY NUMBER:
157209278
ADMINISTRATOR/
DIRECTOR:		RAMIREZ, MAKAYLA MFACILITY TYPE:
737
ADDRESS:15421 JOHNSON RDTELEPHONE:
(661) 340-4457
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY: 4CENSUS: 0DATE:
05/23/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:21 AM
MET WITH:Administrator, Kakayla Ramirez and PLAD, Jill BivinsTIME VISIT/
INSPECTION COMPLETED:
11:50 AM
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On 05/23/2024, Licensing Program Analyst (LPA) Walton arrived for an announced Pre-Licensing Inspection. LPA introduced self, stated the purpose of the visit and was granted entry to the facility. LPA met with Administrator, Mikayla Ramirez and PLAD, Jill Bivins. This is a 4 bedroom and 4 bathroom home. The facility was granted a fire clearance for 4 non-ambulatory clients. The facility has not accepted clients at this time.

Facility tour conducted. Required postings were observed. Facility was observed to be at a comfortable temperature, clean, in good repair, and no passageway obstructions or fire hazards were observed inside or outside. Common areas were properly furnished and had adequate lighting. Fire extinguishers were observed with a service date of: 11/07/2023. Smoke detectors and carbon monoxide detectors were tested and observed to be operational. Facility has a sprinkler system. Kitchen toured. LPA observed dishes and utensils. Knives will be kept in a safe in the kitchen. Cleaning supplies will be kept under the kitchen sink. Medications will be locked and inaccessible to clients in the medication room. The First Aid Kit was observed to have the required supplies.

Residents' bedrooms were observed to be adequately furnished with bed, dresser, a night stand and adequate lightning. Mattresses and box springs were in good condition. A sufficient supply of linens was observed. Bathrooms were observed to be operational. Hot water was tested. Hot water temperature measured between 115.0 - 116.2 degrees F.

Exterior tour conducted. Facility has an in-ground pool. LPA observed a fence at least five-feet high and the fence did not obstruct the pool view. There is a covered patio area outside the facility. Facility is approved for delayed egress.

Component III was also conducted and completed. Exit interview conducted. LPA found that all Pre-licensing Requirements were met. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 05/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/23/2024
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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