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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700930
Report Date: 07/12/2023
Date Signed: 07/12/2023 05:41:49 PM


Document Has Been Signed on 07/12/2023 05:41 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 CARE HOMEFACILITY NUMBER:
342700930
ADMINISTRATOR:KAUR, NAVGEETFACILITY TYPE:
740
ADDRESS:5324 NYODA WAYTELEPHONE:
(951) 775-4933
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 5DATE:
07/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:40 PM
MET WITH:Navgeet KaurTIME COMPLETED:
05:45 PM
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On 7/12/23, LPA Mknelly conducted a visit to the 6/21/23 unfounded complaint finding with R1.

LPA reviewed the investigation and reason for the findings with R1 as well as discussing her continued concerns regarding her health.

LPA found the home to be well maintained and residents receiving appropriate care/ assistance.

As the result of this visit, no deficiencies are noted.

Report reviewed and copy provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2023
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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