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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700802
Report Date: 06/20/2023
Date Signed: 06/20/2023 01:31:41 PM


Document Has Been Signed on 06/20/2023 01:31 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:HAPPY LIFE CARE LIVING, LLCFACILITY NUMBER:
342700802
ADMINISTRATOR:CHADHA, NEHAFACILITY TYPE:
740
ADDRESS:6 TYNDALL CT.TELEPHONE:
(209) 923-7071
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:6CENSUS: 6DATE:
06/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Neha Chadha - AdministratorTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA met with Administrator and explained purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 non-ambulatory residents which 1 may be bedridden and 2 on hospice. Administrator currently holds a certificate #6054348740 that expires on 11/24/2023.

LPA and administrator toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 112.3 degrees Fahrenheit. There is a minimum of 7 day supply of nonperishable and 2 day of perishable foods.

Carbon monoxide was in operating condition during inspection. Based on Administrator, smoke detectors are interconnected with the fire department. Fire extinguisher was last serviced on 6/18/22. Emergency Disaster Plan was last posted on 04/01/2023. Fire drill was last conducted on 04/01/2023. First aid kit was observed to be complete. LPA reviewed two resident files and two staff record files. LPA reviewed a sample of medications of two residents.

LPA received the following updated documents for CCL:
LIC 308 - Designation of Administrator and Liability Insurance

Per the California Code of Regulations, Title 22, Division 6, Chapter 6, no deficiencies were observed during inspection.

Exit interview conducted with Administrator and a copy of report given.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 253-4746
LICENSING EVALUATOR NAME: Ruth WallaceTELEPHONE: (619) 323-4509
LICENSING EVALUATOR SIGNATURE:
DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/20/2023
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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