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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001442
Report Date: 01/24/2025
Date Signed: 01/24/2025 09:25:49 AM

Document Has Been Signed on 01/24/2025 09:25 AM - 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. ACT IIFACILITY NUMBER:
347001442
ADMINISTRATOR/
DIRECTOR:		JAQUEZ, JOEFACILITY TYPE:
775
ADDRESS:9510 ELK GROVE FLORIN RD.,#CTELEPHONE:
(916) 685-7666
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 90CENSUS: 57DATE:
01/24/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Augusta Osayande, Program Director TIME VISIT/
INSPECTION COMPLETED:
09:20 AM
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Licensing Program Analyst (LPA) Victoria Brown and Regional Manager Stephenie Doub arrived unannounced to conduct a required - 1 year visit on 1/24/25 at 9:00am and met with Augusta Osayande, Program Director and stated the purpose of the meeting.


Due to Augusta Osayande, Program Director was providing a hostile environment this visit will be ended. The Department will follow up with the Licensee on a later date.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Victoria Brown
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
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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