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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609853
Report Date: 12/07/2024
Date Signed: 12/07/2024 03:47:33 PM

Document Has Been Signed on 12/07/2024 03:47 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, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME:REESEJOY CARE HOME IIFACILITY NUMBER:
197609853
ADMINISTRATOR/
DIRECTOR:
RAMIREZ, ROBERTOFACILITY TYPE:
740
ADDRESS:17544 SAN JOSE STTELEPHONE:
(805) 832-8792
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 6CENSUS: 4DATE:
12/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:41 AM
MET WITH:Roberto RamirezTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Michael Cava conducted an Annual Required visit and inspection of the facility. LPAs met with the administrator, Roberto Ramirez, and explained the reason for the visit.

At approximately 11:45am, with the assistance of the administrator, LPAs took a tour of the physical plant. Required postings were observed in the entry area. The smoke alarms are battery operated. There is a carbon monoxide detector installed by the kitchen that functions properly. The fire extinguisher is located in the kitchen. It was purchased 10/07/24.

Kitchen: The kitchen appliances and fixtures were functional. LPA found a sufficient amount of perishable and non-perishable food at the facility; properly stored. Knives were stored in a locked drawer in the kitchen. Properly labeled medications were locked in one of the kitchen cabinets.

Bedrooms: There were six (6) bedrooms of which five (5) designated for residents' use, and one (1) room for staff. Three of the bedrooms (rooms #3, #4, #5) are private. Rooms #1 and #2 are shared. Rooms occupied by residents were properly furnished with appropriate beddings and linens with sufficient lighting.

Bathrooms: There are four (4) bathrooms. Three (3) are designated for residents' use. Bathrooms were properly supplied and had functional fixtures. Hot water temperature was between at 105 to 109 degrees Fahrenheit. Cleaning supplies are being stored in the hallway bathroom.

Common Areas: These included the living room and dining area. The living room has a couch, two recliners, television and coffee table. No fireplace. The dining room has a table large enough to seat up to six (6) residents. The auditory alarms on all exit doors were on and functional at the time of the visit.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: REESEJOY CARE HOME II
FACILITY NUMBER: 197609853
VISIT DATE: 12/07/2024
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Floors and furniture were clean and maintained. Hallways and passageways were clear of any obstruction.
Garage: Garage is attached to the home. It is locked and only used as storage. No resident access.

Laundry Area: Laundry area is in the garage. Cleaning supplies and detergents maintained in the garage, which was kept locked during the inspection.

Surrounding Grounds: Entry/exits were free of obstruction. The outdoor area was free of hazards. The laundry area and detergents are located in the garage which is kept locked and inaccessible. The garage is also used as storage area, and staff break room. .

Resident Files: Resident files are kept in a cabinet in the living room. LPA conducted a file review of resident records to insure compliance of licensing forms.

Staff Files: Staff records are kept in a cabinet in the living room. LPA also conducted a file review of staff records to insure forms and training are up to date and compliance with licensing forms.

Medications: Medications are kept locked in a kitchen cabinet. Medication and Medication Records were reviewed for proper storage and documentation.

Pursuant to Title 22 Division 6 of the CA Code of Regulations, there were no deficiencies observed during the visit. Exit Interview Conducted and a copy of the Report Issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2024
LIC809 (FAS) - (06/04)
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