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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397005571
Report Date: 12/08/2021
Date Signed: 12/08/2021 12:45:09 PM

Document Has Been Signed on 12/08/2021 12:45 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:ENCLAVE AT THE DELTAFACILITY NUMBER:
397005571
ADMINISTRATOR:LEAH B ZUBIATEFACILITY TYPE:
735
ADDRESS:4951 EIGHT MILE ROADTELEPHONE:
(209) 210-4863
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 45CENSUS: 41DATE:
12/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Craig Vincelet, SupervisorTIME COMPLETED:
01:00 PM
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On 12/08/2021, Licensing Program Analyst (LPA) T. White, conducted an unannounced case management visit to follow up on an open complaint and pending audit. LPA met with Supervisor, Craig Vincelet and discussed the purpose of the visit.

The purpose of this visit is the Department is conducting a financial audit as a result of an open complaint where additional information was found regarding possible violations of personal rights. The Licensee and/or Licensee Representative for the facility is to provide to the Department all of the following listed documents by 12/30/2021:

· P&I Logs for all facilities January 2021 – Current (Due to the volume this request will only cover this year) – Should an exception be noted further documentation for the exception may be needed.
· All Wealth Wagon Cards sold for all facilities April 2020 – Current
· P&I ledgers for all clients who P&I is being held for, April 2020 - Current
· Status of where all P&I funds are kept – if in a financial institution – Bank statements for April 2020 – Current
· Cash handling policy and procedures
· Copy of Bond for all facilities

This information is used for the purpose of auditing and regulating Community Care Facilities and Residential Care Facilities for the Elderly. Based on interview with Supervisor, the facility has not handled P & I funds since last year. Supervisor is unable to provide exact date. The Supervisor stated the clients have access to there P & I funds which is through the Corporate office.

A copy of this report was provided to the Licensee Representative during this visit.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Treana White
LICENSING EVALUATOR SIGNATURE: DATE: 12/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/08/2021
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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