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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390332359
Report Date: 09/19/2022
Date Signed: 09/19/2022 01:03:15 PM

Document Has Been Signed on 09/19/2022 01:03 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: 22DATE:
09/19/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Laura Reeves - AdministratorTIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Ruth Wallace arrived to conduct an unannounced case management visit to verify a conformation of Staff Removal. LPA explained purpose of visit to Administrator.

Staff #1 (S1) was removed from facility on 8/30/2022. Administrator stated last day worked was 8/29/2022. On this day LPA verified that S1 was not present at the facility. LPA checked staff schedules and did not see the name of S1 listed. Administrator also stated that S1 was not an employee at this facility currently

An exit interview was conducted with Administrator and a copy of this report along with confidential names list was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Ruth Wallace
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2022
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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