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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209319
Report Date: 07/05/2023
Date Signed: 07/05/2023 09:31:24 AM

Document Has Been Signed on 07/05/2023 09:31 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:CENTER STREET BOARD AND CARE 2FACILITY NUMBER:
157209319
ADMINISTRATOR:PENDINGFACILITY TYPE:
735
ADDRESS:2451 CENTER STTELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 18CENSUS: 17DATE:
07/05/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Licensee Anthony BarbatoTIME COMPLETED:
09:30 AM
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Licensing Program Analyst LPA Shawna Doucette conducted an announced visit for a prelicensing. LPA was met by Licensee Anthony Barbato who granted LPA entry into the facility.


LPA attempted the visit however the inspection too for the visit was bringing up an error preventing the LPA from conducting the inspection. LPA will conduct the visit at a later date once the inspection tool error is fixed.

An exit interview was conducted with Licensee and a copy of this report was provided.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 07/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/05/2023
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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