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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700907
Report Date: 01/13/2022
Date Signed: 01/13/2022 03:29:06 PM

Document Has Been Signed on 01/13/2022 03:29 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:HOPEFUL TOMORROW HOMES, LLCFACILITY NUMBER:
342700907
ADMINISTRATOR:ANDRADA, MONALYNFACILITY TYPE:
737
ADDRESS:12857 CHEROKEE LANETELEPHONE:
(916) 890-4282
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY: 4CENSUS: 1DATE:
01/13/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Monalyn Andrada, Administrator TIME COMPLETED:
03:35 PM
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On 01/13/2022, Licensing Program Analysts (LPAs) T. White and M. Jensen arrived unannounced to conduct a required Post-licensing inspection. LPAs met with Direct Support Staff, Dexter Samson and Administrator, Monalyn Andrada. LPAs explained the purpose of today’s inspection. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 4 clients.

LPAs 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 71 degrees Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. There is a minimum of 7-day supply of nonperishable and 2-day of perishable foods.

Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on April 29, 2021. First aid kit was observed to be complete. Fire drill was last conducted on 01/04/2022. LPAs observed completed mitigation plan. LPAs reviewed 1 resident file and medications. LPAs reviewed 2 staff files.

No deficiencies cited 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: 01/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2022
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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