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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340300556
Report Date: 11/08/2024
Date Signed: 11/08/2024 11:23:02 AM

Document Has Been Signed on 11/08/2024 11:23 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ELK GROVE ADULT COMMUNITY TRAINING, INC.FACILITY NUMBER:
340300556
ADMINISTRATOR/
DIRECTOR:		JOE JAQUEZFACILITY TYPE:
775
ADDRESS:8810 ELK GROVE BLVD.TELEPHONE:
(916) 685-7666
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 160CENSUS: 64DATE:
11/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Garrett Keisler, Program DirectorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Victoria Brown arrived unannounced on 11/8/24 at 8:30am to conduct a Case Management visit. LPA met with Garrett Keisler, Program Director and stated the purpose of the visit.

On 7/29/24, LPA conducted an investigation regarding incident reports received by Community Care Licensing (CCL). LPA met with Augusta Osayande. The incidents of potential monies missing occurred between 6/18/24 - 7/5/24. LPA received a copy of the client record that provided the dates, credits, and debit as well as the balance of monies that is maintained at the bank for them.

LPA also received a list of staff who worked in the class during the incident(s). During that visit, LPA conducted interviews of staff #1 (S1-S3). Based on the interviews conducted, it is unclear if the money was lost or stolen by someone. In good faith, the facility has replaced monies to residents and revised the procedures for staff to follow to ensure resident monies remain safe, counted, and logged on a daily basis.

The investigation revealed that although monies were missing from the residents, there is not a preponderance of evidence to cite a deficiency.

Per California Code of Regulations (CCRs) - Title 22, Division 6, Chapter 6, no deficiencies cited. An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Victoria Brown
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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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