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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157204221
Report Date: 04/16/2024
Date Signed: 04/16/2024 07:20:41 PM

Document Has Been Signed on 04/16/2024 07:20 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:SUMMER SPRINGS BOARD & CAREFACILITY NUMBER:
157204221
ADMINISTRATOR/
DIRECTOR:		SOCORRO TELMOFACILITY TYPE:
740
ADDRESS:6112 SUMMER SPRINGS DRIVETELEPHONE:
(661) 397-0416
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 6CENSUS: 6DATE:
04/16/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:02 AM
MET WITH:Administrator Soccorro TelmoTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Licensing Program Analysts (LPA)'s Shawna Doucette and Sarah Hurt arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Administrator Socorro Telmo. LPA disclosed the purpose of the visit and was granted entry into the facility by Staff Teofila Vipug.

A tour of the facility was conducted. LPA's checked the food. LPA's took photos.

LPA's reviewed staff and resident records. LPA's reviewed medications. LPA's took photos.

Due to time constraints, LPA's will return at a later date to complete the inspection and issue any deficiencies or civil penalties.



An exit interview was conducted with the Administrator. A copy of this report was provided via email.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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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