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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700448
Report Date: 11/20/2024
Date Signed: 11/20/2024 11:03:32 AM

Document Has Been Signed on 11/20/2024 11:03 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:NEW HOPE LIVINGFACILITY NUMBER:
312700448
ADMINISTRATOR/
DIRECTOR:
MELEAR, DICKFACILITY TYPE:
740
ADDRESS:208 REBEL CTTELEPHONE:
(916) 258-3957
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
11/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Dick MelearTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced to conduct an annual inspection. LPA met with Dick Melear during today's inspection.

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed three (3) resident rooms and one (1) common area bathroom. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathroom was in sanitary condition, properly maintained, and the hot water temperature was observed to be 120 degrees F.

LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are hard wired in the care home. First aid kit is maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents. LPA reviewed one (1) resident file, two (2) staff files and one (1) resident medications. Facility has a current copy of certificate of liability insurance and LPA obtained a copy.

As a result of this visit, no deficiencies were cited.

Exit interview was conducted with Administrator. A copy of this report provided.
Anthony PerezTELEPHONE: (323) 485-4915
Cassandra MikkelsonTELEPHONE: 916-709-6830
DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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