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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202431
Report Date: 04/11/2023
Date Signed: 04/11/2023 04:05:17 PM


Document Has Been Signed on 04/11/2023 04:05 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:JOYFUL LIVING CARE HOME, LLCFACILITY NUMBER:
157202431
ADMINISTRATOR:JIMENEZ, JOELFACILITY TYPE:
740
ADDRESS:11605 REVOLUTION ROADTELEPHONE:
(661) 587-5968
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:6CENSUS: 5DATE:
04/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:34 PM
MET WITH:Marilyn SasiTIME COMPLETED:
04:25 PM
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On 4/11/23, Licensing Program Analyst (LPA) M. Medina conducted an unannounced Annual Required Inspection. LPA introduced self and stated purpose of visit. LPA allowed entrance by Caregiver. Administrator, Joel Jimenez contacted by telephone and arrived a short time later to conduct today's inspection.

Currently, 5 residents in care. No residents receiving hospice or home health services at this time.

Facility tour conducted with Caregiver and began in resident bedrooms. Rooms observed to have all required accommodations. All areas of the facility have sufficient lighting. Residents bathrooms observed to be clean and in good repair. Bath/tub are have non-skid mats and grab bars. Dining room and living room have adequate seating and lighting for all residents in care. Tour of kitchen conducted. LPA observed adequate food supply for the residents in care. Medications observed to be locked in small cabinet in kitchen cabinet. All chemicals observed to be locked and secured and inaccessible to residents. Smoke and carbon monoxide detectors tested and observed to be operational at time of visit. Carbon monoxide detector present and visible in hallway near resident bedrooms. Fire extinguisher has a service date of 2/23/2023. Last fire drill conducted on 1/26/23 according to facility records.

Outside areas toured. All exits open freely and observed to be free of obstruction. No hazards observed.

All facility staff who require caregiver background checks have received criminal record index clearance or exemptions. LPA received copies of Administrator's certificate, CPR/First Aid car, and LIC 9020 during inspection visit.

No deficiencies cited during visit.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2023
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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