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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157209393
Report Date: 06/01/2024
Date Signed: 06/03/2024 01:03:42 PM

Document Has Been Signed on 06/03/2024 01:03 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:A COMFORT CARE HOME -1FACILITY NUMBER:
157209393
ADMINISTRATOR/
DIRECTOR:
SCHISSLER, EVANGELINEFACILITY TYPE:
740
ADDRESS:6918 NORMANDY ROSE AVETELEPHONE:
(323) 237-4781
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93308
CAPACITY: 8CENSUS: 0DATE:
06/01/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:47 AM
MET WITH:Evangeline Schissler, Licensee TIME VISIT/
INSPECTION COMPLETED:
12:03 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
On 06/01/24, Licensing Program Analyst (LPA) L. Salazar arrived at the facility for an announced pre licensing inspection. LPA was greeted by Licensee/Administrator and was allowed entry into the facility.

LPA toured the facility inside and out with licensee. LPA entered through the front door observed the required postings in the entry. LPA observed the residence to be a single story, 4 bedroom/ 2 bathroom home. There is a dining room and living room observed to have adequate furnishings and lighting. All bedrooms were observed to have beds, however, 4 out of 4 bedrooms have night stands, personal lighting and chest drawers to accommodate 2 residents per room.

LPA observed fire extinguisher to be new and charged. Smoke detectors were tested and observed to be operational. Carbon Monoxide detectors were observed. Night lights in the hallways by the bathrooms were observed. LPA observed a adequate supply of towels. Hand washing signs were observed in the bathrooms. A supply of paper towels were observed in the bathrooms. Hot water temperature in bathroom measured at 114 degrees F. Non-Skid mats were observed in the shower. Grab bars were observed in the bathrooms next to the toilets and showers.

Kitchen observed to have supply of dishes, plates, pots and pans. Food storage and preparation areas are clear and appropriate for food preparation. Cleaning supplies and chemicals are locked in the garage. A locked cabinet in the kitchen is designated to store medications. Sharps/knives were observed in a locked drawer in the kitchen. Appliances observed to be in working order. LPA observed a 7 day supply of non-perishable food.

First aid kit was observed. Washer and Dryer observed in the laundry room with additional storage space available in upper cabinets. Doors and passageways are clear and free from obstruction throughout the home. LPA toured the outside of the residence and observed a cover patio with seating area. Adequate outdoor seating for activities. A self-latching gate found to be working properly. There are no bodies of water on the premises.

Exit interview conducted. LPA will contact the Central Applications Bureau and advise that facility is ready for license.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2024
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