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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374601232
Report Date: 12/28/2023
Date Signed: 12/28/2023 04:46:42 PM

Document Has Been Signed on 12/28/2023 04:46 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
CCLD Regional Office, 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: 6DATE:
12/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:27 AM
MET WITH:Licensee Ligaya SandersTIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Dang Nguyen and Liliana Silveira conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPAs were welcomed by and identified themselves to volunteer Lisa Vance. LPA then met and discussed the purpose of the visit with Licensee Ligaya Sanders, who arrived later during the visit.

During today’s visit, LPAs toured the facility, reviewed staff and client records, and interviewed staff and clients.

Upon arriving to the facility, LPAs observed that Volunteer #1 (V1) was left alone at the facility to supervise four clients who were physically present (C1 through C4). Per interview of V1: for a period of approximately 25 to 30 minutes, there was no facility staff present at the facility to supervise or assist V1, as was required. The Licensee and another staff then arrived at the facility. Per regulation, volunteers may “not be included in the facility staffing plan” and “shall be supervised” at all times. The absence of staff to accompany V1 meant that clients were temporarily not supervised.



Due to time constraints, a return visit on a subsequent day is needed to complete the annual inspection.

One (1) deficiency was cited per California Code of Regulations, Title 22. An immediately civil penalty of $500 was also assessed (refer to the LIC421-IM). A Plan of Correction was jointly developed with the licensee.

An exit interview was conducted the Sanders, to whom a copy of this report, the LIC809-D, the LIC421-IM, and the Licensee/Appeal Rights (LIC9058 03/22) were provided during the visit.
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Dang Nguyen
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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Document Has Been Signed on 12/28/2023 04:46 PM - It Cannot Be Edited


Created By: Dang Nguyen On 12/28/2023 at 04:30 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: 12/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
80078(a)
80078 Responsibility for Providing Care and Supervision: “(a) The licensee shall provide care and supervision as necessary to meet client’s needs.” This requirement was not met, as evidenced by:
Deficient Practice Statement
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Based on LPA observation and staff interview, for 4 of 6 clients (C1 through C4), the licensee did not provide care and supervision as necessary to meet clients’ needs. This posed an immediate health, safety, and personal rights risk to persons in care.
POC Due Date: 12/28/2023
Plan of Correction
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Upon arriving to the facility, LPA’s phoned Licensee. Licensee arrived at the facility around ten minutes later, followed by another staff, to resume client care and supervision. This action resolved the immediate risk. LPAs advised licensee that volunteers cannot substitute for trained staff.
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:Lizzette Tellez
LICENSING EVALUATOR NAME:Dang Nguyen
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2023


LIC809 (FAS) - (06/04)
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