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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002960
Report Date: 03/05/2024
Date Signed: 04/08/2024 09:57:36 AM


Document Has Been Signed on 04/08/2024 09:57 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:JOY'S CARE HOME-ELMFACILITY NUMBER:
315002960
ADMINISTRATOR:SUSBILLA, GLORIA JOYCE BROFACILITY TYPE:
740
ADDRESS:256 ELM STREETTELEPHONE:
(916) 297-5675
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:6CENSUS: 5DATE:
03/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Joy Bron- SusbillaTIME COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 3/5/24 to conduct a Annual Inspection utilizing the CARE inspection tool. LPA met with Licensee and Admin for the review.

LPA and caregiver toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedroom, kitchen and dining. In the areas toured no immediate health, safety, or personal rights violations were observed.
The home is clean and odor free. Residents appear to have their care needs met. House and water temperatures are within required range. Food supplies and quality meet requirements.

LPA reviewed resident files. Advisories provided.
Staff files were reviewed. File is complete.


As a result of this inspection,no deficiencies are cited.
Exit interview conducted. Report copy and appeal rights provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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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