<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209146
Report Date: 10/22/2024
Date Signed: 10/22/2024 11:22:33 AM

Document Has Been Signed on 10/22/2024 11:22 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:QUALITY CARE ASSISTED LIVINGFACILITY NUMBER:
157209146
ADMINISTRATOR/
DIRECTOR:		ESPINAL, ALMAFACILITY TYPE:
740
ADDRESS:2607 MT. VERNON AVENUETELEPHONE:
(661) 871-8133
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 54CENSUS: DATE:
10/22/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Licensee Kristine Juarez and Alma EspinalTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/22/24 Licensee Kristine Juarez arrived at the Fresno Regional Office and requested to meet with Licensing Program Analyst Shawna Doucette. Licensing Program Analyst Shawna Doucette and Licensing Program Manager See Moua met with Licensee Kristine Juarez and Alma Espinol.

The purpose of the meeting was to discuss the complaint received on 10/16/24 and the documents that were requested from the complaint inspection. During today’s meeting, copies of all utility bills that was requested were provided to the LPA. POC for the substantiated complaint was provided during the meeting.

LPA and LPM also followed up on R1 for the complaint received on 10/16/24. The complaint alleges that R1 AWOL from the facility and was missing. Information was provided that R1 was found at the hospital. R1 was reassessed and requires a higher level of care. Hospital case worker is working on discharging R1 to a nursing facility.

During the meeting, facility roster was provided.

A copy of this report was provided.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1