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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157208817
Report Date: 06/27/2023
Date Signed: 06/27/2023 02:34:55 PM

Document Has Been Signed on 06/27/2023 02:34 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:BOGGS FACILITYFACILITY NUMBER:
157208817
ADMINISTRATOR:MARCUS HUFFFACILITY TYPE:
740
ADDRESS:810 DARLINGHAM COURTTELEPHONE:
(661) 282-1438
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY: 4CENSUS: 4DATE:
06/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Sharon Thomas, Administrator
Kelly Wejmar, House Manager		TIME COMPLETED:
02:55 PM
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On 6/27/23, Licensing Program Analyst (LPA) conducted an unannounced Annual Required Inspection. LPA introduced self and stated purpose of visit. LPA allowed entrance by Sharon Thomas, Administrator. Also present during inspection was Kelly Wejmar, House Manager.

Facility tour conducted with Administrator and House Manger. Facility was observed at a comfortable temperature, clean, in good repair. Resident rooms toured, all bedrooms were observed to be adequately furnished with adequate lightning. Kitchen toured, LPA observed facility to have a 2-day supply of perishable and a 7-day of non-perishable food available. Bathrooms were properly equipped and fixtures operational. Hot water was tested at 106 degrees F in the bathrooms. Common areas were properly furnished and have adequate seating available. Medications observed to be locked and secured in hall closet. Medications observed to have original labels and be administered as prescribed.

Fire extinguisher was observed with a purchase date of 7/22/22. Carbon monoxide and smoke detectors were tested and observed to be operational. Cleaning supplies and chemicals are locked and secured in laundry room.

Outside of facility toured. All exits are free of obstruction

No deficiencies observed during today's inspection. Exit Interview conducted with Administrator and a copy of this report provided for facility records.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2023
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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