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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700964
Report Date: 02/21/2021
Date Signed: 08/04/2021 12:08:21 PM

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:GARDEN OF JOYFACILITY NUMBER:
342700964
ADMINISTRATOR:UWOGHIREN, DRUSILLAFACILITY TYPE:
740
ADDRESS:3908 BRANCH STREETTELEPHONE:
(510) 375-6903
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY:6CENSUS: 0DATE:
02/21/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Drusilla Uwoghiren.TIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Avelina Martinez contacted the facility via telephone to conduct a follow up correction pre-licensing visit on 02/21/2021 due to COVID-19 and pre-cautionary measures. LPA Martinez identified herself and discussed the purpose of the call and the elements of the pre-licensing visit with Drusilla Uwoghiren.

Facility has a fire clearance for 6 non-ambulatory residents. Administrator, Drusilla Uwoghiren, will be the Administrator of this facility. The facility administrator’s certificate #:6044309740, and expires: 05/02/20201.

LPA Martinez inspected the interior and exterior of the facility via virtual visit. The facility was observed to be in substantial compliance, and component 3 was completed with Drusilla Uwoghiren.

The facility had an adequate food supply. The facility also has a sufficient supply of utensils, plates, and bowls. The facility's kitchen water temperature was 108.9 degrees. The facility has emergency food and water kit. The facility's living room and common room were furnished, and the facility has a public phone for residents. The facility's laundry room has a locked cabinet for cleaning supplies and has a sufficient supply of linens. The bathrooms are equipped with non-slip tub mats, grab bars, night lights, and hygiene products. The bathroom water temperature was 106 degrees. All bedroom were supplied with furniture and linens. All smoke detectors, carbon detectors, and fire extinguishers are in good repair and up to date. The facility has staff, resident, medication, and fire drill binders, which all are complete. The facility has a first aid kit, and the facility has an emergency disaster plan 610E. The exterior of facility has chairs in shaded area. The exterior has an emergency exit gate. Continued..

SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Avelina MartinezTELEPHONE: (915) 431-8935
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2021
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: GARDEN OF JOY
FACILITY NUMBER: 342700964
VISIT DATE: 02/21/2021
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The applicant has passed the pre-licensing component of the application process. LPA will notify the Central Application Bureau (CAB) that the pre-licensing has been completed and passed.

An exit interview was conducted with Applicant Drusilla Uwoghiren via telephone and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents.

SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Avelina MartinezTELEPHONE: (915) 431-8935
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2021
LIC809 (FAS) - (06/04)
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