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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209320
Report Date: 03/29/2023
Date Signed: 03/29/2023 03:23:04 PM

Document Has Been Signed on 03/29/2023 03:23 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:CENTER STREET BOARD AND CAREFACILITY NUMBER:
157209320
ADMINISTRATOR:WALKER, FELLINIFACILITY TYPE:
735
ADDRESS:2431 CENTER STTELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 22CENSUS: 16DATE:
03/29/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:11 AM
MET WITH:Licensee, Anthony BarbatoTIME COMPLETED:
12:08 PM
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Licensing Program Analyst (LPA) Darius Williams conducted an announced Pre-Licensing inspection. LPA Williams met with Licensee Anthony Barbato and discussed the purpose of the visit.

LPA Williams and the Licensee began the tour in the living room. LPA Williams observed a television, one couch that could sit two people, and three chairs. There was no phone present on the premises.
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Bedrooms had a bed, required linins, dresser, night stand, working light, and chair. The rooms were free of debris and any obstructions.

There are three bathrooms in the facility. Bathroom 1 had approximately 3 inch area of dry wall missing near the bottom left of the toilet. Bathrooms 2 floor was wet and there was no non slip map present. Additionally, approximately 4 inch edging tile was dislocated from the outside shower wall. Bathroom 3 was missing a mirror . Zero of three bathrooms had a toilet paper dispenser.

Food is prepared at, Center Street Board and Care 2, approximately 15 feet from the facility. The kitchen was clean and in good repair. Water temperature reflected approximately 115.3 degree Fahrenheit, via facility thermometer.

Extra hygiene, medication, and sharps, were observed behind a locked door inaccessible to clients.

Carbon monoxide, smoke detectors, and fire extinguishers were present and operational.

*Continued on LIC 9099C*
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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
FACILITY NUMBER: 157209320
VISIT DATE: 03/29/2023
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There is no pool on the premises. There are covered patios on each side of the facility providing shelter and shade from the elements.

Licensee has agreed to address the following items.

- Add seating to the living room to accommodate the clients.
- Add a phone line
- Bathroom 1: Fix 3 inch area dry wall repair near toilet.
- Bathroom 2: repair tile outside of shower
- Bathroom 3: Add a mirror and fix towel rack
- All bathrooms: Add toilet dispensers and non-slip mats.

Component III was discussed and reviewed with the Licensee.

LPA Williams will conduct a follow up Pre-Licensing inspection on 4/6/2023 , regarding the items identified.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC809 (FAS) - (06/04)
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