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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209423
Report Date: 09/06/2024
Date Signed: 09/06/2024 10:24:36 AM

Document Has Been Signed on 09/06/2024 10:24 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:
09/06/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:03 AM
MET WITH:Administrator, Charles Heard TIME VISIT/
INSPECTION COMPLETED:
10:34 AM
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On 09/06/2024, Licensing Program Analyst (LPA) Walton arrived for an announced case management- pre-licensing continuation inspection. LPA introduced self, stated the purpose of the visit and met with Administrator, Charles Heard.

During today's visit LPA toured client bathrooms. Bathrooms were observed to be operational. Hot water measured at 111.6 degrees F.

I have found that the applicant has met all pre-licensing requirements. LPA will submit documentation to CAB in Sacramento for final review prior to license being issued.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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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