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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 032701224
Report Date: 05/16/2023
Date Signed: 05/16/2023 11:20:41 AM

Document Has Been Signed on 05/16/2023 11:20 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:ARGONAUT CARE HOME 2FACILITY NUMBER:
032701224
ADMINISTRATOR:IKISEH, CHUKWUDIFACILITY TYPE:
740
ADDRESS:840 ARGONAUT DR.TELEPHONE:
(209) 268-0597
CITY:JACKSONSTATE: CAZIP CODE:
95642
CAPACITY: 6CENSUS: 3DATE:
05/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Shadae JamesTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Christina Valerio and LPA Victoria Brown arrived unannounced to the facility to conduct a case management visit. LPAs met with caregiver, and explained the purpose of the visit.

The purpose of the visit was to document findings from the previous pre-licensing visit on to current license. Information regarding the visit can be found under license #032701224. Facility staff contacted the facility administrator to inform of LPAs arrival. LPAs observed the physical plant to ensure compliance of Title 22 regulations. LPAs spoke to Chukwudi Ikiseh via cell phone.

A follow-up visit will be conduct to continue pre-licensing inspection. An exit interview was held with Chukwidi Ikiseh, and a copy of the report provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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