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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340300556
Report Date: 05/20/2025
Date Signed: 05/20/2025 12:06:05 PM

Document Has Been Signed on 05/20/2025 12:06 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
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: 74DATE:
05/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:JOE JAQUEZTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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At approximately 9:15 AM, Licensing Program Analysts (LPAs) Sommer Hayes and Arvin Villanueva arrived unannounced to conduct a Required 1 Year inspection and was greeted by Executive Director, Joe Jaquez and Program Director, Augusta Osayande. Elk Grove Adult Community Training is Licensed as a Day Program.

The current census is 74.

At approximately 9:45AM, LPAs toured the facility with Administrator Joe Jaquez and Program Director, Augusta Osayande and Program Director, Garrett Keisler. There were 4 classrooms with an average of 15-16 clients in each.. LPAs observed each classrooms to have at least 2 bathrooms for clients use. LPAs observed in the classrooms clients enjoying activities, some dancing, playing with toys and interacting with staff and others on Zoom. LPAs observed a wide variety of activities, curriculum and games for participants. Exits were clear and unobstructed. The facility's fire extinguishers in each room were last serviced and tagged on 12/24/2024 by River City Fire. LPAs observed a wide variety of fruits and snacks for the clients to enjoy. Clients also bring their lunches to the program, and they are stored and labeled in their classrooms. Small Garden shovels were left behind the sprinkle controls across from the transportation area.

Rooms 2A and 2C had a carbon monoxide detector and a fire detector with pull alarms. 1 of 2 bathrooms had a hot water temperature was 119.6. This building had a full kitchen. A 3-inch knife was found in a drawer in the kitchen. Program Director, Augusta Osayande had staff immediately remove the scissors into a locked sharps cabinet. The temperature on the thermostat was 72 degrees. LPAs observed clients participating in group activities in both rooms. Smoke detectors were observed.

Continued on 809-C..

NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Sommer Hayes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ELK GROVE ADULT COMMUNITY TRAINING, INC.
FACILITY NUMBER: 340300556
VISIT DATE: 05/20/2025
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Room 3 had a carbon monoxide detector and a fire detector with pull alarms. 1 of 2 bathrooms had a hot water temperature of 117 degrees. LPAs observed the refrigerator was locked with a combination lock for clients who presented behaviors. A staff member unlocked the refrigerator for inspection. LPAs observed a small kitchen knife inside of the dishwasher. Program Director, Augusta Osayande had staff immediately remove the knife into a locked sharps cabinet. The thermostat had a room temperature reading of 68 degrees. No smoke detectors were observed. LPAs observed clients were actively engaged in classroom activities.

Room 4 This room had clients who are independent who are learning to prepare meals, wash dishes and do laundry. LPAs observed a pair of full-size scissors with a black handle was left unlocked in the dish rack in the kitchen. Program Director, Augusta Osayande had staff immediately remove the scissors into a locked sharps cabinet. Clients were seen engaging in activities with each other and independently. LPAs observed clients were actively engaged in classroom activities. There were a variety of games, media options and other activities for clients.

Room 5 LPAs observed clients interactively participating in activities, walking, sitting and enjoying toys and other activities. 1 of 2 bathrooms had a hot water temperature of 112 degrees. The thermostat had a room temperature reading of 69 degrees. No smoke detectors were observed. LPAs observed a carbon monoxide detector. LPAs observed clients actively engaged in classroom activities.

Based on today's visit, this Annual Visit will need continuation.

Exit interview was conducted and a copy of this report was provided. .

NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Sommer Hayes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC809 (FAS) - (06/04)
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