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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209257
Report Date: 11/25/2024
Date Signed: 11/25/2024 12:19:07 PM

Document Has Been Signed on 11/25/2024 12:19 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:IVY PARK AT SEVEN OAKSFACILITY NUMBER:
157209257
ADMINISTRATOR/
DIRECTOR:		BRADLEY, PAMELAFACILITY TYPE:
740
ADDRESS:4301 AND 4225 BUENA VISTA ROADTELEPHONE:
(661) 837-1337
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 164CENSUS: 102DATE:
11/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Health Service Director Annette EgglestonTIME VISIT/
INSPECTION COMPLETED:
12:18 PM
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On 11/25/24, Licensing Program Analysts (LPA) M. Yang arrived unannounced for a case management - other inspection regarding immediate exclusion of Staff 1 (S1). LPA introduce self, stated the purpose of the visit and requested to meet with Administrator. Administrator Pamela Anderson was not available. LPA met with Health Service Director (HSD) Annette Eggleston.

LPA was informed by Administrator via telephone on 11/22/24, that excluded staff member is not associated with facility and have not been employed by the facility. Personnel Record (Lic 500) was provided to LPA and was reviewed. Lic 500 confirms S1 is not working at the facility.

No deficiency was observed.

Exit Interview was conducted. A copy of this report was provided to HSD, whose signature confirms receipt of this report.
SUPERVISORS NAME: See Moua
LICENSING EVALUATOR NAME: Mai Yang
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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