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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003287
Report Date: 12/28/2023
Date Signed: 12/28/2023 04:28:16 PM


Document Has Been Signed on 12/28/2023 04:28 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:JONES CAREFACILITY NUMBER:
347003287
ADMINISTRATOR:JONES, JIMMIEFACILITY TYPE:
740
ADDRESS:9559 LAZY SADDLE WAYTELEPHONE:
(916) 761-5204
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:6CENSUS: 0DATE:
12/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:TIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Victoria Brown arrived unannounced to conduct a closure visit on 12/28/2023 at 3:30p. LPA met with Jovita Aduca, Caregiver and stated the purpose of the visit. This caregiver is unrelated to Jones Care but is working for Royal Grove Care Home.

LPA received a call from Jimmie Jones indicating that he is still being billed for the license.
However, there has been a change of ownership (CHOW) which occurred on 12/14/2022. The new facility was called Jones Care @ Saddle Way.

On 12/14/22, there were 6 residents in the Jones Care facility. The same 6 residents resided in the facility address for Jones Care @ Saddle Way. Per Jimmie Jones, at some point, possibly after 6 months, the residents were relocated by their conservators.
The new licensee for this address is Royal Grove Care Home which was previously Jones Care @ Saddle Way.
During this visit, LPA was met by 2 caregivers working for Royal Grove Care Home and there are 2 residents presently. The 2 residents residing in the facility now are not part of the census that was under Jones Care. Royal Grove Care Home was licensed under this address 1/26/23.

LPA requested copies of notices given to previous residents, date of closure, reason for closure, conservator contact information as well as resident relocation information to be faxed to Community Care Licensing (CCL) along with answers to the facility closure survey. In addition, the Original license is to be mailed to CCL. Jimmie Jones agreed. Based on this information, facility number will be closed as of 1/26/23 when Jones Care @ Saddle Way was licensed.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Victoria BrownTELEPHONE: (209) 814-1955
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2023
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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