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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209136
Report Date: 08/06/2021
Date Signed: 08/06/2021 12:54:52 PM

Document Has Been Signed on 08/06/2021 12:54 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:REDWOOD SENIOR LIVING BAKERSFIELDFACILITY NUMBER:
157209136
ADMINISTRATOR:ESPINAL, KENNYFACILITY TYPE:
740
ADDRESS:810 S UNION AVETELEPHONE:
(415) 810-0145
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 41CENSUS: 37DATE:
08/06/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Administrator, Barket Hussain and Licensee, Anthony BarbatoTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Darius Williams conducted an unannounced Case Management visit regarding a reported AWOL by the facility. LPA Williams met with Administrator Barket Hussain and discussed the purpose of the visit.

LPA Williams toured the facility, backyard, and Resident 1's bedroom with the Administrator.

LPA Williams interviewed Administrator and Licensee, Anthony Barbato.

LPA Williams received copies of Resident 1's records.

Due to insufficient information available at this time the case management requires further investigation.

An exit interview was conducted and a copy of this report was provided.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2021
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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