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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 247209177
Report Date: 03/08/2023
Date Signed: 03/09/2023 03:32:20 PM


Document Has Been Signed on 03/09/2023 03:32 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
SIERRA CASCADE AC/SC, 1314 E SHAW AVE
FRESNO, CA 93710



FACILITY NAME:JOY JOYCE RESIDENTIAL CARE HOMEFACILITY NUMBER:
247209177
ADMINISTRATOR:MUTUA, CATHERINE NFACILITY TYPE:
740
ADDRESS:263 ARROYO CTTELEPHONE:
(510) 292-1577
CITY:MERCEDSTATE: CAZIP CODE:
95341
CAPACITY:6CENSUS: 4DATE:
03/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Catherine Mutua - AdministratorTIME COMPLETED:
01:15 PM
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On 3/8/2023, Licensing Program Analyst(LPA) D. Ayers arrived unannounced at the facility to conduct a Required Annual Inspection. LPA met with caregiver Airen Miro and spoke with Administrator Catherine Mutua. Administrator was unable to be at the facility during the inspection and agreed to have facility staff sign the licensing report on her behalf.

LPA toured the facility inside and outside. Pathways and doors were clear and free from obstruction. Smoke-detectors and carbon-monoxide detectors were present and operational. Facility fire extinguisher was recently serviced. Facility was clean and odor free. LPA observed sufficient amount of perishable and non-perishable foodstuffs. Common areas were clean, adequately furnished, and adequately lit. Resident bedrooms were clean and had required minimum furnishings. Resident bathrooms were clean, had required secure grab bars and non-skid mats, and water temperature was within required temperature range. Sharp items were secured in a locked drawer in the kitchen. A locked closet was observed to store resident medications, and medications appeared to be administered properly. The fence had a self-locking latch mechanism, and there was adequate outdoor seating for residents. LPA reviewed facility plan of operations and emergency disaster plan. LPA reviewed staff and resident files.
LPA requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610-E the Emergency Disaster Plan, proof of liability insurance, and copy of current Administrator’s Certificate to update the facility file.
No deficiencies were cited during the inspection. Exit interview was conducted with the Licensees. A copy of the report was provided.
SUPERVISOR'S NAME: Brenda ChanTELEPHONE: (650) 266-8889
LICENSING EVALUATOR NAME: David AyersTELEPHONE: 559-498-4163
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2023
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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