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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209308
Report Date: 04/27/2023
Date Signed: 04/28/2023 12:59:51 PM

Document Has Been Signed on 04/28/2023 12:59 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:PATHWAY HOME CAREFACILITY NUMBER:
157209308
ADMINISTRATOR:JOHNSON, JONATHANFACILITY TYPE:
740
ADDRESS:414 LANSING DRIVETELEPHONE:
(661) 972-4646
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93309
CAPACITY: 4CENSUS: 0DATE:
04/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Administrator, Jonathan JohnsonTIME COMPLETED:
11:14 AM
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Licensing Program Analyst (LPA) Darius Williams conducted a follow up Pre-licensing visit. LPA Williams met with Administrator, Jonathan Johnson and discussed the purpose of the visit.

The following items were addressed since last inspection visit on 4/6/2023:

- Hot water temperature reflected approximately 106.1 F.
- Bathroom 2 had non-slip strips in shower.
- Facility had an operational phone line.
- Facility thermostat displayed 72 degrees F.
- Chairs and umbrella were available for residents on the patio.
- Plan of Operation was present and reviewed.

Report will be submitted to CAB for further review.

An exit interview was conducted and a copy of this report will be provided via e-mail.
SUPERVISORS NAME: Serigy Pidgirny
LICENSING EVALUATOR NAME: Darius Williams
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
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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