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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209275
Report Date: 01/29/2025
Date Signed: 01/29/2025 12:24:45 PM

Document Has Been Signed on 01/29/2025 12:24 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:CENTRAL VALLEY RESIDENTIAL CARE, LLCFACILITY NUMBER:
157209275
ADMINISTRATOR/
DIRECTOR:		RIVAS, MARK JOSEPHFACILITY TYPE:
740
ADDRESS:6727 SHAVER DRIVETELEPHONE:
(626) 977-4093
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 6CENSUS: 0DATE:
01/29/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Administrator Mark RivasTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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
Licensing Program Analyst (LPA) Shawna Doucette arrived at the facility unannounced to conduct an annual Required Inspection. LPA was granted entry into the facility by Administrator Mark Joseph Rivas.

LPA toured the facility. LPA observed 3 bedrooms downstairs designated as resident rooms. Facility has an upstairs that is not accessible to residents with 3 bedrooms and 2 bathrooms upstairs. Resident rooms were clean and fully furnished. LPA observed cleaning supplies to be locked in the garage. Water temperature was 115 F.

Knives were locked in a kitchen drawer. Medications are locked in a kitchen cabinet.

Smoke detector and carbon monoxide is operating. Facility has a sprinkler system. Smoke alarms are hard wired into the alarm system.

Fire extinguisher was serviced 1/30/24.

LPA reviewed Administrator file. Administrator has current certificate. File was complete.


An exit interview was conducted with Administrator.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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