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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700498
Report Date: 06/22/2022
Date Signed: 06/24/2022 07:42:29 AM

Document Has Been Signed on 06/24/2022 07:42 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:BRIGHT FUTURES 3FACILITY NUMBER:
392700498
ADMINISTRATOR:FERLANDO JACKSONFACILITY TYPE:
735
ADDRESS:14151 N TULLY RDTELEPHONE:
(209) 727-5350
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY: 5CENSUS: 5DATE:
06/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Ferlando Jackson, AdministratorTIME COMPLETED:
03:50 PM
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On 06/22/2022 at 2:00 PM, Licensing Program Analyst (LPA) T. White arrived unannounced to conduct a required 1-year Annual inspection. LPA met with Administrator, Ferlando Jackson and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 5 clients.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. LPA observed locked swimming pool in the backyard. A comfortable temperature for clients is maintained at 77 degree Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 111.4 degree Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishables foods.

Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on February 08, 2022. Emergency Disaster Plan was last posted on 11/04/2021. First aid kit was observed to be complete. Fire drill was last conducted on 05/30/2022.

No deficiencies cited during inspection. Exit interview conducted with Administrator and a copy of report given.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Treana White
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2022
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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