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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700930
Report Date: 02/26/2021
Date Signed: 02/26/2021 09:09:53 AM

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:HELPING HANDS CARE HOMEFACILITY NUMBER:
342700930
ADMINISTRATOR:KAUR, NAVGEETFACILITY TYPE:
740
ADDRESS:5324 NYODA WAYTELEPHONE:
(951) 775-4933
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 0DATE:
02/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Navgeet Kaur, Administrator TIME COMPLETED:
08:30 AM
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Licensing Program Analyst (LPA) Sabrina Calzada conducted a follow up tele-visit with Navgeet Kaur, Administrator to ensure noted areas of deficiency from 2/22/2021 Pre-Licensing tele-visit are in compliance. LPA observed the following areas to now be in compliance per Title 22, Division 6, Chapter 8:
  • LPA observed that the drawer/area to be used for sharps and medications in the kitchen, and the area to be used for toxins in the laundry room now has a locking mechanism installed.

  • LPA observed one resident room to be complete with required furniture- bed, night stand, lamp, dresser and chair.

  • LPA observed that a grab bar was installed by the toilet in two bathrooms.

  • LPA observed a complete a first aid kit on site

  • LPA observed hot water to be measured at 117*F in the kitchen.

  • LPA observed exit doors to have alarms on them.

  • LPA observed a complete sample resident and staff binder to be put together with required paperwork.

  • LPA observed multiple games and activities on site.


Pre-Licensing deficiencies have been resolved. Pre-Licensing is now complete.
Exit interview done. Copy of report emailed to Administrator who agrees to return a signed copy of today's report to the department by end of day, 2/26/2021.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2021
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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