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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004679
Report Date: 05/02/2024
Date Signed: 05/02/2024 12:00:50 PM


Document Has Been Signed on 05/02/2024 12:00 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:GLORIOUS HOMES #1FACILITY NUMBER:
347004679
ADMINISTRATOR:OFFIAH, MICHAEL & WINIFREDFACILITY TYPE:
740
ADDRESS:6901 FRANELA WAYTELEPHONE:
(916) 242-0735
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:6CENSUS: 4DATE:
05/02/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Administrator- Michael OffiahTIME COMPLETED:
12:05 PM
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On 05/02/24 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the inspection tool. LPA met with Administrator, Michael Offiah, and explained the purpose of the visit.

LPA and administrator conducted a tour of the facility. Areas toured include but not limited to three (3) shared resident bedrooms, resident bathrooms, staff room, kitchen, garage, backyard and common areas. LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. LPA observed residents' bathrooms to be clean, sanitary, and in good repair. LPA observed food supplies of non-perishables for a minimum of seven (7) days and perishable foods for a minimum of two (2) days. Toxins, knives and cleaning supplies are locked and inaccessible to residents in care. The hot water temperature was measured in the kitchen at 108.3 degrees Fahrenheit. The facility's temperature was 74 degrees Fahrenheit during inspection. LPA observed fire detectors and carbon monoxide alarms to be operable. LPA observed medications to be locked and inaccessible to residents in care. LPA observed required Licensing posters posted throughout the facility. LPA reviewed a total of two (2) resident files and two (2) staff files.

The following shall be updated and submitted to Community Care Licensing by 05/09/2024:
-LIC 500 facility personnel or staff schedule
-LIC 308 designation of administrative responsibility
- A copy of the current liability insurance

No deficiencies being cited during today's inspection.

Exit interview conducted and a copy of the report was left at the facility.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Cheyenne RatajczakTELEPHONE: (916) 969-7879
LICENSING EVALUATOR SIGNATURE:
DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/02/2024
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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