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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107208977
Report Date: 08/02/2022
Date Signed: 08/02/2022 01:49:47 PM

Document Has Been Signed on 08/02/2022 01:49 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:JAN-ROY PLACE OF FRESNOFACILITY NUMBER:
107208977
ADMINISTRATOR:HOPPER, JOYCELYNFACILITY TYPE:
740
ADDRESS:4766 EAST ILLINOIS AVETELEPHONE:
(559) 940-9708
CITY:FRESNOSTATE: CAZIP CODE:
93702
CAPACITY: 6CENSUS: 4DATE:
08/02/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:Administrator, Joycelyn HopperTIME COMPLETED:
02:04 PM
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On 08/02/2022, Licensing Program Analyst (LPA) Walton arrived unannounced to conduct a POC inspection. LPA introduced self, stated the purpose of the visit, and requested to meet with the Administrator. LPA met with Administrator, Joycelyn Hopper

On 06/21/2022, LPA conducted an annual inspection at the above facility. During the inspection the facility was issued 2 citations based on California Code of Regulations section 87303(a) and 87555(b)(26). Administrator agreed to repair facility blinds, repair/secure window screens, and stock the facility with a minimum two day supply of perishable foods. Administrator was given a plan of correction date of 07/21/2022.

On 07/29/2022, LPA conducted a POC visit and observed a two day supply of perishable foods. LPA did not observe the window screens in the living rooms and bedroom 1 and bedroom 3 to be in good condition.

The purpose of today's visit is to clear citations issued on 06/21/2022 and assess civil penalties from 07/22/2022 through 07/28/2022. Administrator submitted proof of correction to the Fresno CCL office on 07/29/2022. LPA confirmed corrections were made during this inspection.

A civil penalty is being assessed in accordance to California Code of Regulations for failure to correct for the period of 07/22/2022 through 07/28/2022 (7 days) in the amount of $100 per day for a total of $700.

Exit interview conducted. A copy of this report was discussed and provided to Administrator, Joycelyn Hopper , whose signature on this form confirms receipt of this document.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Alexandria Walton
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2022
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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