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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701331
Report Date: 01/13/2025
Date Signed: 01/13/2025 12:30:11 PM

Document Has Been Signed on 01/13/2025 12:30 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NEW HOPE DAY PROGRAMFACILITY NUMBER:
342701331
ADMINISTRATOR/
DIRECTOR:		BAGASAN, FRANCISFACILITY TYPE:
775
ADDRESS:9701 DINO DR SUITE 170TELEPHONE:
(916) 230-4087
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 30CENSUS: 27DATE:
01/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Francis BagasanTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 01/13/25, Licensing Program Analyst, (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct an annual inspection. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Designated Facility Administrator. Staff contacted the Administrator, Francis Bagasan, the two met and a brief interview followed.

LPA began by comparing the staff roster to the list of those with background clearances in Guardian to ensure that all staff had been background cleared to work with the clients at this adult day program. All were in compliance at the time of this inspection.

Administrator's certificate (# 7015982735) expires 05/09/2026. LPA observed the certificate was posted along with Client Rights, "See Something, Say Something," grievance procedures, and emergency phone numbers on a bulletin board in the hallway.

LPA and the Designated Facility Administrator toured the facility. LPA inspected all rooms and common areas including but not limited to: the kitchen/break room, locker area, arts and crafts room, exercise room, quiet room, storage room, computer/activities areas, a multi-media room, restrooms and offices. All knives and sharps were locked and inaccessible to clients. Restrooms contained required grab bars, soap dispensers and paper towels. LPA measured the hot water to ensure it was between the required 105 and 120 degrees Fahrenheit. The hot water measured 116.3 degrees and was in compliance at the time of this inspection. The thermostat in the activities room was set at 70 degrees Fahrenheit and was also in compliance at the time of this inspection.

This facility does not provide meals, but it does provide snacks. This LPA inspected the food supply to ensure that none of the food items were past their due date and that everything was appropriately packaged and stored properly.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: NEW HOPE DAY PROGRAM
FACILITY NUMBER: 342701331
VISIT DATE: 01/13/2025
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Fire extinguishers were last inspected by River City Fire Equipment Co. on 01/02/25 and all 3 were in compliance at the time of this inspection. During the tour this LPA observed 4 clients and 2 staff interacting in the exercise room which contained a blow-up bowling set, magnetic darts, a punching bag, and more.

Clients then went on an outing to the grocery store in preparation for a cooking class on Wednesday. Upon return, LPA observed clients participating in a birthday party for one of the members of the program.

This facility has staff trained to assist with medication administration but at the time of inspection, none of the clients required medications and there were no medications or logs to inspect.

During this visit, this LPA collected the following:
A copy of the Administrator's Certificate
LIC 500
LIC 9020
Updated 610 D
Updates LIC 308
Copy of the lease

Staff and resident files were readily available for review during this visit. LPA reviewed Resident (R1) - (R3) and Staff (S1) - (S3) files. All were in compliance at the time of this inspection.

Per the California Code of Regulations, Title 22 no deficiencies were observed or cited during this visit.

Exit interview held, copy of report given.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2025
LIC809 (FAS) - (06/04)
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