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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 297004181
Report Date: 08/23/2024
Date Signed: 09/23/2024 02:05:16 PM

Document Has Been Signed on 09/23/2024 02:05 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:HELPING HANDS CAREGIVER RESOURCEFACILITY NUMBER:
297004181
ADMINISTRATOR/
DIRECTOR:		COLEEN BONDFACILITY TYPE:
775
ADDRESS:17645 PENN VALLEY DRIVETELEPHONE:
(530) 432-2540
CITY:PENN VALLEYSTATE: CAZIP CODE:
95946
CAPACITY: 30CENSUS: 22DATE:
08/23/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Stephanie Murphy, Social WorkerTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 8-23-2024 LPA Tryon visited the program to do an annual inspection. LPA toured the program including classrooms, offices, kitchen, quiet room, bathrooms, outside. The program appears to be well-organized and well-equipped to meet the needs of the participants. The program is spacious with plenty of room and activities. The rooms are clean and well-furnished. Bathrooms are clean and functioning properly. Fire extinguishers are present and charged, are checked regularly. Smoke detector/fire system installed. Kitchen was clean and well-kept.

At this time, the program was closing and staff had to be elsewhere; therefore LPA will return at a later date to complete the annual review and the CARES Tool.

No issues were noted regarding the physical setting.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2024
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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