<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209304
Report Date: 01/27/2024
Date Signed: 01/29/2024 02:57:15 PM


Document Has Been Signed on 01/29/2024 02:57 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
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:HALLMARK OF BAKERSFIELDFACILITY NUMBER:
157209304
ADMINISTRATOR:CANDELAS, ASHLEY L.FACILITY TYPE:
740
ADDRESS:2001 AKERS ROADTELEPHONE:
(661) 834-0200
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY:99CENSUS: 60DATE:
01/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Facility Medication Technician, Melinda Alfano TIME COMPLETED:
04:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Sarah Hurt conducted an unannounced facility visit to conduct a Case Management visit. LPA met with facility staff facility Medication Technician, and explained the purpose of today's visit. LPA Hurt also read the report vis phone to Facility Wellness Director, Tiffany Luaces

LPA Hurt toured the facility including entryway, and upstairs area of the facility.

LPA reviewed four incident reports documenting Resident 1 displaying aggressive behavior towards facility Resident 2.

On 01/23/24 Resident 1 nudged Resident 2 with her walker on the back of the legs as Resident 2 was getting on the elevator. Resident 1 proceeded to tell Resident 2 to remove her shirt that it belonged to her. The shirt belonged to Resident 2 and it has Resident 2's name on it.

On 01/15/24 Resident 1 and Resident 2 were sitting in front of the lobby. Resident 1 approached Resident 2 and told that they were wearing their sweatshirt backwards, to take it off and put it on the right way. Resident 2 thanked Resident 1 and proceeded to remove the shirt to when Resident 1 snatched it from her and started yelling that it was theirs. Staff 1 intervened and let the residents know to start arguing. Resident 1 continued to argue with staff and use profound language. Staff 1 separated them and let management know.

The facility could not provide an itemized list of Resident 1's personal belongings.

The following Deficiencies are being cited Per Title 22 Regulations.

Exit interview conducted with Facility Medication Technician, Melinda Alfano, and a copy of this report
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 01/29/2024 02:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710


FACILITY NAME: HALLMARK OF BAKERSFIELD
FACILITY NUMBER: 157209304

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/10/2024
Section Cited
CCR
87468.1(a)(1)

1
2
3
4
5
6
7
87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. The following requirement has not been met as evidenced by:
1
2
3
4
5
6
7
Administrator will make a plan to keep Resident 1 from violating the rights of Resident 1, and sybmit proof to LPA by 02/10/2024.
8
9
10
11
12
13
14
Resident 1 has violated the personal rignts on Resident 2 on several during several separate documented incidents, which poses a potential, health, safety, or personal rights risk to residents in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sarah HurtTELEPHONE: 559-243-8080
LICENSING EVALUATOR SIGNATURE:
DATE: 01/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/27/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2