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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209286
Report Date: 06/05/2024
Date Signed: 06/05/2024 01:06:20 PM

Document Has Been Signed on 06/05/2024 01:06 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:SCHOOL HOUSE LANEFACILITY NUMBER:
157209286
ADMINISTRATOR/
DIRECTOR:
DURAN, RONALDFACILITY TYPE:
735
ADDRESS:7104 SCHOOL HOUSE LANETELEPHONE:
(661) 454-9324
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 4DATE:
06/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Ronald DuranTIME VISIT/
INSPECTION COMPLETED:
01:26 PM
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On 6/05/2024, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self, stated purpose of visit, and allowed entrance by care staff.

Facility currently has four (4) residents in placement. Facility accepted first admission in March 2024. All residents were at day program at time of inspection. Residents attend day program Monday through Friday 8:30 AM to 2:30 PM.

LPA conducted facility tour with Ronald Duran, Administrator. LPA observed facility to be clean, odor free, and a comfortable temperature. Facility is a 4 bedroom home and all residents have private bedrooms. All bedrooms observed to have required furnishings. Bathrooms toured, and observed to have non-slip mats available. Water temperature measured at 110 degrees F. All common areas observed to have adequate seating for all residents. Kitchen toured, LPA observed a 2-day supply of perishable and 7-day supply of non-perishable food available for residents. All sharps are locked and secured in the bottom drawer in the kitchen. Medication reviewed, all medication observed to have original labels and to be administered as prescribed by physician. Centrally stored medication logs and MARS reviewed. Medications observed to be locked and secured in the medication cabinet.

Facility is equipped with a fire sprinkler system and 2 pull stations. Last fire drill conducted on 4/1/2024. Smoke detectors and carbon monoxide detectors observed operational during inspection. First Aid kit observed to have all required items.

Outside of facility toured. Exits open free of obstructions. No hazards observed. All chemicals observed to be locked and stored in garage and inaccessible to residents.

No deficiencies observed during inspection.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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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