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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700901
Report Date: 06/25/2024
Date Signed: 06/25/2024 12:31:12 PM

Document Has Been Signed on 06/25/2024 12:31 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:A LOVING AND JOYFUL HOME RCFEFACILITY NUMBER:
312700901
ADMINISTRATOR/
DIRECTOR:
HEYDON, ANITAFACILITY TYPE:
740
ADDRESS:609 HERNANDEZ LANETELEPHONE:
(916) 918-2429
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 6DATE:
06/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Anita Heydon, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection. LPA met with Ritu Rani, caregiver, who contacted the Administrator, Anita Heydon, by phone. LPA spoke to the Administrator by phone and stated the reason for the inspection. Administrator arrived to the facility shortly. Also present was staff, Roma Devi. LPA was informed there were (5) residents present at the start of the inspection and (1) resident returned from the hospital during today's inspection.

During today's inspection, LPA obtained copies of documentation from each resident's file.

LPA and Administrator toured the facility and observed (4) residents to be resting in their rooms, (1) resident to be finishing lunch in the kitchen, and (1) resident to be watching television in the common area.

There are no deficiencies issued in today's report.

Exit interview. Copy of report provided to the Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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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