<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397005571
Report Date: 03/21/2024
Date Signed: 04/26/2024 10:04:32 AM

Document Has Been Signed on 04/26/2024 10:04 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ENCLAVE AT THE DELTAFACILITY NUMBER:
397005571
ADMINISTRATOR:LO, SUSANFACILITY TYPE:
735
ADDRESS:4951 EIGHT MILE ROADTELEPHONE:
(209) 210-4863
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 45CENSUS: 37DATE:
03/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:39 AM
MET WITH:Susan Lo, Assistant AdministratorTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Renee Campbell arrived unannounced to complete a required annual inspection. Upon arrival, LPA Campbell observed three residents sitting outside. When LPA Campbell entered the building, one resident was standing at the door speaking on their phone and offered to get staff for the LPA. LPA Campell was greeted by Caregiver Latriece Anacreon and was allowed to work in the staff lounge

The facility is a one floor building licensed to service forty-five adults ages 18 to 59.  Six of the clients may be non-ambulatory and two of them may be bedridden. No body of water was found. A resident was seen walking away from the facility down the road. Per Assistant Administrator Lo, the resident had signed out as required. LPA Campbell inspected the physical plant including but not limited to the common area, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations.  The facility was observed to be free of odor and in good repair. The outside areas were observed to be well maintained with no obstructions.



While setting up a work space in the lounge, LPA Campbell observed a resident shouting while talking to himself. Staff attempted to de-escalate with verbal assurance and by presenting a calm tone and demeanor. The administrator arrived ten minutes later and provided the necessary files for review. A tour of the facility was conducted. The hot water was measured at 119.4 degrees Fahrenheit which is between the range of 105 to 125 degrees Fahrenheit. The thermostat was set at 73 degrees. The fire extinguishers were last inspected on January 19, 2024 and were fully charged. A room for a washer and dryer and cleaning supplies was observed while staff and one resident did the laundry. cont. 9099-c
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ENCLAVE AT THE DELTA
FACILITY NUMBER: 397005571
VISIT DATE: 03/21/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Of the 37 residents, LPA Campbell reviewed 4 of their files. Per California Code of Regulations, Title 22 there were no deficiencies cited during today's inspection. An exit interview was conducted, and a copy of this report was left at the facility. 
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE:

DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2