019200247-4-20-2026-15-AS-KNGN-DTBSKU-20260420135721

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 019200247
Report Date: 04/20/2026
Date Signed: 04/20/2026 01:57:41 PM

Document Has Been Signed on 04/20/2026 01:57 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, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME:	JOYCE HOME		FACILITY NUMBER:	019200247
ADMINISTRATOR/ DIRECTOR:	VIRGINIA M. MARCELO		FACILITY TYPE:	735
ADDRESS:	24749 JOYCE ST.		TELEPHONE:	(510) 673-2948
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94544
CAPACITY: 6		CENSUS: 6	DATE:	04/20/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Nicole Marcelo, Co-Administrator		TIME VISIT/ INSPECTION COMPLETED:	02:25 PM

NARRATIVE

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On this day, at around 9:30 am, Licensing Program Analyst (LPA) K. Nguyen arrived unannounced to conduct an annual required inspection. LPA was met by caregiver Belinda Cruz. LPA explained the purpose of the visit to Belinda. Licensees Nicanor and Nicole Marcelo Co-Administrator arrived at the facility later. The facility is a Level 4F home vendorized by the Regional Center of the East Bay (RCEB).

LPA inspected the facility inside and out, including but not limited to 3 client rooms, dining, kitchen, garage, and backyard. There was a supply of linen, towels, and warm blankets available for the client's use. Hygiene products were observed to be available. Fire extinguishers appeared full and were last serviced on 4/20/26. Smoke detectors were tested and observed to be functional. The last earthquake drill was conducted on April 06, 2026. The last fire drill was conducted on 2/19/2026. Hot water temperature measured 118.4 F. Liability effective from 11/17/25 to 11/17/26.

At 12:00 PM, LPA reviewed 6 clients and 4 staff files. All staff are fingerprint cleared and associated with the facility. They have current First Aid/CPR training.

At 12:30 PM, LPA verified the P & I money, logged it, and observed that the records are accurate and the money is intact. The facility has a surety bond sufficient to cover the amount of money being handled at one time.

Deficiency observed during today's visit:

- At around 11 am, LPA observed that the refrigerator light was in disrepair.

Deficiencies cited per Title 22 California Code of Regulations and listed on LIC809D. Failure to submit proof of corrections (POC) by the plan of correction due date and/or any repeat deficiencies within a 12-month period may result in civil penalties.

An exit interview was conducted with Nicole Marcelo, and Appeal Rights were provided.

NAME OF LICENSING PROGRAM MANAGER: Bennett Fong
NAME OF LICENSING PROGRAM ANALYST: Kelly Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/20/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 04/20/2026 01:57 PM - It Cannot Be Edited

Created By: Kelly Nguyen On 04/20/2026 at 01:21 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612

FACILITY NAME: JOYCE HOME	FACILITY NUMBER: 019200247
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/20/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

80087(a)

Building and Grounds

(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in by having the refrigerator light was in disrepair, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/04/2026
	Plan of Correction
1 2 3 4	Licensee agree to fix the light in the refrigerator and submit proof via email to CCLD by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Bennett Fong
NAME OF LICENSING PROGRAM MANAGER:

	Kelly Nguyen
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/20/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2026

LIC809 (FAS) - (06/04)

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