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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601232
Report Date: 09/21/2022
Date Signed: 09/21/2022 04:29:13 PM

Document Has Been Signed on 09/21/2022 04:29 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:JOY'S HOMECAREFACILITY NUMBER:
374601232
ADMINISTRATOR:LIGAYA SANDERSFACILITY TYPE:
735
ADDRESS:1406 I AVENUETELEPHONE:
(619) 474-0198
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 6CENSUS: 5DATE:
09/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Celia GarciaTIME COMPLETED:
04:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Renita Hall, conducted an unannounced Required 1 – Year Visit. The facility file was reviewed prior to the visit. LPA met with Celia Garcia and we discussed the purpose of the visit. All staff present do not have a current criminal record clearance.


LPA conducted a tour of the facility, both inside and outside. In accordance with the Department’s Infection Control, LPA evaluated and observed the facility's implementation of their mitigation plan to include disinfection, testing surveillance, and screening protocols as well as the use of personal protective equipment.

During today's visit, LPA observed Staff 1 (see LIC811 Confidential Names List) working at the facility. S1 does have a criminal record exemption, however, it is not associated to the facility.

The Licensee arrived during the visit and stated that she was unaware S1's criminal record exemption has not been properly transferred to the facility. The Licensee acknowledged S1 cannot be at the facility until S1 is properly associated to the facility. In the meantime, the Licensee will be the staff on site. Prior to delivering this report, LPA observed S1 leave the facility's premises an immediate civil penalty of $500 is charged on this date.

An exit interview was conducted. The Licensee was provided a copy of their appeal rights (LIC9058 03/22), along with a copy of this report.
SUPERVISORS NAME: John Rante
LICENSING EVALUATOR NAME: Renita Hall
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2022
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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Document Has Been Signed on 09/21/2022 04:29 PM - It Cannot Be Edited


Created By: Renita Hall On 09/21/2022 at 03:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108

FACILITY NAME: JOY'S HOMECARE
FACILITY NUMBER: 374601232

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
80019(e)(3)
80019 Criminal Record Clearance (e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall prior to working, residing or volunteering, in a licensed facility. (3) Request and be approved for a transfer of a criminal record exemption, as specified in Section 80019.1(r), unless upon request to transfer the Department permits the indvidual to be employed, reside or be present at the facility.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in one out of five staff which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/23/2022
Plan of Correction
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The Licensee will read this regulation section and send a certification to CCLD that she read and understands this section and acknowledges Staff 1 will not be at the facility until the exemption is appropriately transferred by POC due date 09/23/22
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:John Rante
LICENSING EVALUATOR NAME:Renita Hall
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2022


LIC809 (FAS) - (06/04)
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