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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209216
Report Date: 07/20/2022
Date Signed: 07/20/2022 11:36:39 AM

Document Has Been Signed on 07/20/2022 11:36 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:PATHWAY HOMESFACILITY NUMBER:
157209216
ADMINISTRATOR:JOHNSON, JAIMYFACILITY TYPE:
740
ADDRESS:336 MONTCLAIR STTELEPHONE:
(661) 972-6051
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 0DATE:
07/20/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Jaimy Johnson, Administrator
Jason Johnson, Licensee		TIME COMPLETED:
11:50 AM
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On 7/20/22 at 9:15 AM, Licensing Program Analyst (LPA) Malia Thao arrived announced to conduct a Prelicensing inspection. LPA met with Administrator Jaimy Johnson and Licensee Jason Johnson.

LPA conducted tour of inside and outside of the facility. No obstructions observed. All bedrooms have sufficient furniture and lighting. One grab bar observed for use of toilet and shower in both hallway and master bathrooms. Non-skid strips observed for both showers. Facility set at comfortable temperature. Fire extinguisher was purchased on 2/5/22. Dishware and utensils observed. Centrally stored medication observed designated to locked hall closet. First aid kit observed complete.

The following observed will need to be brought into compliance:
1. Hot water in hallway bathroom measured at 86 degrees F.
2. Facility telephone not in service.
3. Baseboards around toilet area in both hall and master bathroom observed with gap between wall and baseboard.
4. Need proof of liability insurance.
5. Facility does not have a designated inaccessible cabinet for disinfectants and cleaning solutions.
6. Need updated facility yard sketch.

Comp III completed. Facility telephone number is: 661-735-7005. A follow-up inspection to be scheduled once all above items are in compliance.

Exit interview conducted. A copy of this report was given to Administrator Jaimy Johnson, whose signature confirms receipt of this report.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Malia Thao
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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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