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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701110
Report Date: 01/12/2022
Date Signed: 01/13/2022 08:36:41 AM

Document Has Been Signed on 01/13/2022 08:36 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:LIFE PATHWAY VOCATIONAL DEVELOPMENT CENTERFACILITY NUMBER:
392701110
ADMINISTRATOR:ENUNWA, JOHNFACILITY TYPE:
775
ADDRESS:9305 THORNTON ROAD SUITE ETELEPHONE:
(310) 953-1378
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY: 30CENSUS: 0DATE:
01/12/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:John EnunwaTIME COMPLETED:
03:15 PM
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Licensing Program Analysts Bruce Jacobs met with applicant John Enunwa to conduct a Pre- Licensing inspection for this new Adult Day Program. The Program is in the process of obtaining vendorization with the Regional Center.

LPA toured the facility including common areas, activity area, three client bathrooms and outside area. Requested capacity is 30 clients. The facility is clean and in good repair and no odors were detected in areas toured. No hazards were noted in the activity areas, hallways, doorways, etc. No equipment was stored in public areas. Fixtures and furniture all appear to be in good condition. Cleaning solutions will stored separately from food and are secured. Handrails are present in all toilet areas. Room temperature was comfortable in facility. There are no bodies of water on the premises. A Fire Clearance was granted on 12/22/21 for 30 ambulatory clients and a total capacity of 30.

LPA observed an adequate physical area for capacity requested. Physical plant appears consistent with facility sketch. Facility has supply of bedding and towels. Furniture and fixtures appear to be appropriate and adequate storage space available. There are 3 bathrooms for the clients. Emergency lighting available. Kitchen/break area appears to be clean, well supplied with equipment. Cooler/freezer appear to be at appropriate temperatures. Facility has no current client or staff files at this time First aid supplies are available Lighting and emergency lighting are working The facility submitted a COVID mitigation plan that was reviewed by LPA.

Component III was provided. LPA reviewed Personnel Policies, Abuse Reporting Procedures, In-Service Training and Medications Procedures.

Facility is ready for licensure. Exit interview conducted and copy of this report given to Mr. Enunwa
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Bruce Jacobs
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2022
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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