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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390332359
Report Date: 04/21/2022
Date Signed: 04/21/2022 01:34:32 PM

Document Has Been Signed on 04/21/2022 01:34 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:HANOT FOUNDATIONFACILITY NUMBER:
390332359
ADMINISTRATOR:REEVES, LAURA L.FACILITY TYPE:
735
ADDRESS:14373 EAST SARGENTTELEPHONE:
(209) 334-6454
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY: 30CENSUS: 25DATE:
04/21/2022
TYPE OF VISIT:Required - 1 YearANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Laura Reeves, Executive DirectorTIME COMPLETED:
01:45 PM
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 At 9:00 am, Licensing Program Analysts (PAs) T. White and R. Campbell arrived unannounced to conduct a required 1-year Annual inspection. LPAs met with Executive Director, Laura Reeves and explained the purpose of today’s inspection. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 30 clients, of which five may be non-ambulatory.

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. There are no bodies of water observed. A comfortable temperature for clients is maintained at 74 degree Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature tested at 118.2 and 113.1 degrees Fahrenheit. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishables foods.

LPAs observed smoke detectors interconnected with the fire department anCarbon Monoxide in operating condition during inspection. Fire extinguisher was last serviced on 02/07/2022. LPAs observed completed mitigation plan. First aid kit observed to be complete. Fire drill was last conducted on 03/01/22. LPAs reviewed 6 client files and 6 staff record files.

No deficiencies cited during inspection.

Exit interview conducted with Executive Director and a copy of report given.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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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