342701238-4-27-2026-27-AS-KVIA-DTK7EY-20260427213642

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342701238
Report Date: 04/27/2026
Date Signed: 04/27/2026 09:37:17 PM

Document Has Been Signed on 04/27/2026 09:37 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:	STAYPOINT RESIDENTIAL		FACILITY NUMBER:	342701238
ADMINISTRATOR/ DIRECTOR:	PATRICK OFOSE		FACILITY TYPE:	735
ADDRESS:	167 DANNY DR		TELEPHONE:	(408) 373-7750
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY: 6		CENSUS: 4	DATE:	04/27/2026
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Patrick Ofose, Administrator		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	on 04/27/26, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct the annual inspection. LPA identified herself upon arrival, stated the purpose of the visit, and asked to meet with the Designated Facility Administrator. LPA was met by staff and the Administrator, Patrick Ofose, arrived approximately 30 minutes later. LPA observed that Administrator Certificate, # 7012282735 expires on 02/22/27 and was in compliance. While waiting from the Administrator, the LPA began a document review. LPA compared Guardian Roster to the staff schedule to ensure that all staff had the required background clearances. All were in compliance at the time of this inspection. LPA then proceeded to conduct a file review. LPA reviewed 2 staff and 2 resident files, all were in compliance at this time. The kitchen was then inspected and this LPA observed a 2-day perishable and 7-day nonperishable food supply. All knives and sharps were locked and inaccessible to residents in care. The fire extinguisher was last inspected by Fire Code Safety Equipment on 08/06/25 and was in compliance at the time of this inspection. LPA inspected all common areas in addition to the resident rooms. All had the required furniture, furnishings and lighting to be in compliance at the time of this inspection. Each resident room was equipped with a lock for privacy. The (2) resident bathrooms were inspected. LPA observed soap and paper towels in each. The hot water was measured to ensure it was within the range of 105 - 120 degrees Fahrenheit. Hot water measured 107.8 degrees Fahrenheit during this inspection.

NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Kimberly Viarella
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026

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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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: STAYPOINT RESIDENTIAL	FACILITY NUMBER: 342701238
	VISIT DATE: 04/27/2026

NARRATIVE

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Medications were observed to be in a locked cabinet in the kitchen with overstock located in a locked closet. LPA reviewed administration, storage, and destruction with Administrator. All were in compliance at the time of this inspection. Staff led LPA on a tour of the exterior of the building. There was one outbuilding that contained a desk and exercise equipment for residents to use.

All window screens and gutters were in good repair at the time of this inspection. The yard was completely fenced in and there were no bodies of water present. There was also a shaded area with furniture for residents to enjoy.

LPA provided technical assistance regarding the lack of door handle on the outbuilding, and the pothole that was observed in the concrete on the side of the house.

LPA requested the following documents be emailed to CCLASCPSacramentoSouthRO@dss.ca.gov with a copy to Kimberly.Viarella@dss.ca.gov by 05/04/26.

· LIC 500: Personnel Report; please update and remove any staff no longer employed and include all new hires in Guardian.
· A copy of your Resident/Client Roster
· LIC 308: Designation of Administrative Responsibility
· LIC 309: (for any LLC or Corp) if applicable
· LIC 402: Surety Bond, if applicable
· LIC 610E: Emergency Disaster Plan
· Copy of Liability Insurance
· An updated lease agreement, if applicable.
· An updated Facility Sketch

According to the California Code of Regulations, Title 22, no deficiencies were cited during today's visit, a copy of this report was provided and an exit interview was conducted with Ofose.

NAME OF LICENSING PROGRAM MANAGER: Stephen Richardson
NAME OF LICENSING PROGRAM ANALYST: Kimberly Viarella
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/27/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2026

LIC809 (FAS) - (06/04)

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