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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019200734
Report Date: 05/31/2024
Date Signed: 05/31/2024 11:16:10 AM


Document Has Been Signed on 05/31/2024 11:16 AM - 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:JOY SENIOR CENTERFACILITY NUMBER:
019200734
ADMINISTRATOR:MATHARU, GURPREETFACILITY TYPE:
740
ADDRESS:6400 BRENTWOOD BLVDTELEPHONE:
(510) 543-4695
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:18CENSUS: 14DATE:
05/31/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH: Rose Constantino, Caregiver TIME COMPLETED:
11:30 AM
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On 5/31/2024 at 09:30AM, Licensing Program Analysts (LPAs) J. Clancy-Czuleger and T. Syess- Gibson conducted an unannounced Case Management visit to follow-up on the accusation document that was provided to the facility. LPA met with Rose Constantino, Caregiver and explained the purpose of the visit. Licensee Gurpreet "Bobby" Matharu, was called and agreed to have Rose sign off on the report.

LPA toured facility with Caregiver, Rose Constantino and observed the facility posted written notice regarding the accusation. LPA confirm that all fourteen (14) residents have received written. During visit LPA obtained the notice that was posted in the facility and the notice that was sent to the residents or their responsible party.

Exit interview conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Harpreet HumpalTELEPHONE: (510) 285-3928
LICENSING EVALUATOR NAME: Jill Clancy-CzulegerTELEPHONE: 510-286-4201
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2024
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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