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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002960
Report Date: 02/01/2024
Date Signed: 02/02/2024 09:32:16 AM

Document Has Been Signed on 02/02/2024 09:32 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:JOY'S CARE HOME-ELMFACILITY NUMBER:
315002960
ADMINISTRATOR:SUSBILLA, GLORIA JOYCE BROFACILITY TYPE:
740
ADDRESS:256 ELM STREETTELEPHONE:
(916) 297-5675
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 5DATE:
02/01/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Joy and Calvin Bron- SusbillaTIME COMPLETED:
12:45 PM
NARRATIVE
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On 2/1/24, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit while delivering complaint findings and met with Licensee and Administrator .

LPA is following up on issues that have occurred during a dissolved change of ownership.

The party that had purchased the business and intended to apply for a license is no longer continuing with the process. The business purchaser and the licensee are currently in process of a settlement to dissolve the business deal.

At issue, and as discussed in a 1/10/14 office meeting with the licensee, is that the property was leased to the intending buyer before a new license was granted. Therefore, the licensee has lost control of property.

Also during the business deal process the entities were in dispute regarding the fees to be charged to R1. To resolve the issue, the licensee had R1 move to another of their licensed homes. With the dissolving of the business deal, R1 has returned to this home. That move of R1 violated R1's personal rights.

As a result of this inspection, the following deficiencies were cited on 809-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care.

Report reviewed. Copy of report and appeal rights provided
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2024
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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Document Has Been Signed on 02/02/2024 09:32 AM - It Cannot Be Edited


Created By: Kevin Mknelly On 02/01/2024 at 12:13 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JOY'S CARE HOME-ELM
FACILITY NUMBER: 315002960

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/02/2024
Section Cited
HSC
1569.191(b)

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Transferability of License-(b)..., the property and business shall not be transferred until the buyer qualifies for a license or provisional license...
This requiremnt was not met based on interviews and records.
This poses an immediate risk to the residents.
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Licensee will inform the department of their legal council's plan to re-establish a lease agreement for the licensee.
The tentative plan is to be submitted by 5 PM on 2/2/24.
Additionally a Non-comliance Conference is to be scheduled with the licensee.
Type B
02/08/2024
Section Cited
CCR
87468.2(a)(16)

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Additional Personal Rights of Residents in Privately Operated Facilities- (16) To written notice of any room changes at least 30 days in advance unless a room change is agreed to by the resident, required to fill a vacant bed, or necessary due to an emergency.
This requiremtn was not met based on
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Licensee and administrator will submit a statement that they have reviewed this regulation, understand and will comply with it's content.
This POC is due by 2/8/24
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records and statements that R1 was not served notice and the reason for the move did not meet regulation criterea.
This posed a potential risk to the resident.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maribeth Senty
LICENSING EVALUATOR NAME:Kevin Mknelly
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2024


LIC809 (FAS) - (06/04)
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