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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197609853
Report Date: 10/26/2022
Date Signed: 10/26/2022 11:55:32 AM


Document Has Been Signed on 10/26/2022 11:55 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, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364



FACILITY NAME:REESEJOY CARE HOME IIFACILITY NUMBER:
197609853
ADMINISTRATOR:RAMIREZ, ROBERTOFACILITY TYPE:
740
ADDRESS:17544 SAN JOSE STTELEPHONE:
(805) 832-8792
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Albert Dela Vega/ AdministratorTIME COMPLETED:
12:15 PM
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Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in order to conduct an infection control annual. The LPA was greeted by the facility administrator. The LPA's temperature was taken upon entry and all COVID-19 protocols were taken.

The home consists of 5 bedrooms and 2 bathrooms. The LPA was able to test the smoke alarms and carbon monoxide detectors, which all functioned properly. A fire extinguisher was observed in the kitchen to be functional.

The facility is currently following their infection control plan and no deficiencies were observed during the visit.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Patrick ShanahanTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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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