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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700802
Report Date: 06/14/2022
Date Signed: 06/15/2022 08:42:14 AM

Document Has Been Signed on 06/15/2022 08:42 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:HAPPY LIFE CARE LIVING, LLCFACILITY NUMBER:
342700802
ADMINISTRATOR:CHADHA, NEHAFACILITY TYPE:
740
ADDRESS:6 TYNDALL CT.TELEPHONE:
(209) 923-7071
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 6CENSUS: 6DATE:
06/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Neha Chadha, AdministratorTIME COMPLETED:
03:40 PM
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On 06/14/2022 at 1:20 PM, Licensing Program Analyst (LPA) T. White arrived unannounced to conduct a Required 1-year annual inspection. LPA met with Administrator, Neha Chadha and explained the purpose of today’s inspection. LPA was allowed entry into the facility that is licensed to serve a total capacity of 6 non-ambulatory residents which 1 may be bedridden and 2 on hospice. Administrator currently holds a certificate #6054348740 that expires on 11/24/2023.

LPA toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 109.6 degrees Fahrenheit. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.

Carbon monoxide was in operating condition during inspection. Based on Administrator, smoke detectors are interconnected with the fire department. Fire extinguisher was last serviced on July 09, 2021. Emergency Disaster Plan was last posted on 04/01/2022. Fire drill was last conducted on 04/01/2022. First aid kit was observed to be complete. LPA reviewed 4 resident files and 3 staff record files. LPA reviewed a sample of medications of 4 residents.

Per the California Code of Regulations, Title 22, Division 6, Chapter 6, no deficiencies were observed during inspection.

Exit interview conducted with Administrator and a copy of report given.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Treana White
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2022
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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