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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 032701225
Report Date: 06/09/2023
Date Signed: 06/10/2023 04:09:55 PM

Document Has Been Signed on 06/10/2023 04:09 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:ARGONAUT CARE HOME 3FACILITY NUMBER:
032701225
ADMINISTRATOR:NGAIMA, MAMAFACILITY TYPE:
740
ADDRESS:10575 RIDGECREST DR.TELEPHONE:
(209) 268-0597
CITY:JACKSONSTATE: CAZIP CODE:
95642
CAPACITY: 6CENSUS: 3DATE:
06/09/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Shadae JamesTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPA) Christina Valerio and LPA Arielle Pacua arrived to the facility unannounced to conduct a continued pre-licensing inspection. LPA met with facility staff and explained the purpose of the visit, which is to ensure previous pre-licensing deficiencies have been cleared.

LPAs observed the physical plant. LPAs observed 3 residents in care. Bedrooms, bathrooms, and common areas had necessary furniture and furnishings. LPAs were checking the water temperature, which read at 105.1* degrees F. LPAs heard a noise coming from the garage and entered the garage. LPAs were met by two women that were putting belongings inside the dressers located in the garage. LPAs observed one mattress and one blow up bed with bed coverings. The two women later identified themselves as staff for Argonaut Care Home 2 and Argonaut Care Home 3. LPAs immediately contacted Licensee/Facility Staff Sylvester Okoro and Chukwidi "Patrick" Ikiseh to inform them of LPAs observations. LPM Richardson was also notified.

Based on this observation, the pre-licensing deficiencies have not been resolved. Pre-licensing is incomplete. An exit interview was held with staff, and report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2023
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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