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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700964
Report Date: 02/04/2022
Date Signed: 02/04/2022 02:26:05 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: 5DATE:
02/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:DRUSILLA UWOGHIRENTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Anthony Tuck arrived to conduct an unannounced annual inspection on 02/04/2022. LPA met with staff Drusilla Uwoghiren and explained the purpose of the visit. Drusilla Uwoghiren is the Administrator and holds certificate #6044309740 that expires on 05/07/2023.

This facility is a single story building licensed to serve six (6) ambulatory residents of which 2 may be bedridden and a hospice waiver for 2. LPA toured the physical plant including but not limited to two resident bedrooms, two resident bathrooms, garage and backyard area. LPA observed the facility to be free of odor, clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. There are no bodies of water present.

LPA observed sufficient seven day non-perishable and two day perishable food supplies. Hot water temperature was measured at (116.8) degrees Fahrenheit in resident bathroom sink, which is within the required regulation of 105 to 120 degrees Fahrenheit. Fire extinguishers and smoke and carbon monoxide detectors are in compliance with fire safety. Fire extinguisher last serviced 02/17/2021. Thermostat observed at (72) degrees Fahrenheit.

LPA observed centrally stored medications, toxins and sharp knives kept locked and inaccessible to clients. LPA reviewed resident and staff roster, and staff associations to the facility. First aid kit was checked and is complete. LPA learned that the facility is in process of starting 2 staff and waiting for finger print transfer request to be processed.

The following forms documents were received during today's visit on 02/04/2022:
LIC 500, LIC 9020, LIC 610, copy of administrator certificate.

No deficiencies were found during today's inspection. Exit interview held with Drusilla Uwoghiren and a copy of report given at the conclusion of the visit.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Anthony TuckTELEPHONE: (916) 708-6203
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2022
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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