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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209423
Report Date: 08/26/2024
Date Signed: 08/26/2024 11:48:25 AM

Document Has Been Signed on 08/26/2024 11:48 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:ALBRAY MAXWELLFACILITY NUMBER:
157209423
ADMINISTRATOR/
DIRECTOR:		HEARD, CHARLESFACILITY TYPE:
775
ADDRESS:325 19TH STTELEPHONE:
(661) 342-1914
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY: 60CENSUS: 0DATE:
08/26/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:14 AM
MET WITH:Administrator, Charles Heard, Operations Manager, Joe Correa, Licensee, Damian BoldenTIME VISIT/
INSPECTION COMPLETED:
12:02 PM
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On 08/26/2024, 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, Charles Heard, Operations Manager, Joe Correa, Licensee, Damian Bolden.

LPA toured inside and outside of the facility. No fire hazards or passageway obstructions were observed. The facility has various activity rooms. Facility has lockers accessible to clients to secure personal belongings. Facility will have quiet room for clients as needed. LPA observed sufficient seating and adequate lighting throughout the facility. LPA toured the client restrooms, restrooms did not deliver hot water. Meals will be provided by a third party. Facility dining area toured and appeared clean. LPA observed a locked cabinet where chemicals will be stored. Fire extinguishers were last serviced on 02/19/2024. First Aid Kit observed. Fire alarm tested and observed to be operational.

Component III was conducted during today's pre-licensing inspection.

LPA is requesting that the facility repair faucets in 3 out of 3 bathrooms to allow for hot water to be delivered.

LPA will return at a later date to confirm if the repairs have been made.

LPA will notify CAB that the facility is ready to be licensed once the above corrections have been made.

SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 08/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2024
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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