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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701443
Report Date: 03/11/2025
Date Signed: 03/11/2025 12:42:24 PM

Document Has Been Signed on 03/11/2025 12:42 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:TOP VALLEY CARE HOMEFACILITY NUMBER:
392701443
ADMINISTRATOR/
DIRECTOR:		GARCIA, MANUELFACILITY TYPE:
735
ADDRESS:2538 PINASCO RDTELEPHONE:
(209) 888-4320
CITY:STOCKTONSTATE: CAZIP CODE:
95215
CAPACITY: 4CENSUS: 0DATE:
03/11/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Manuel GarciaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analysts (LPAs) Michael Bilger and Noel Wolf Petersen conducted an announced pre-licensing visit to this facility on 3/11/2025 at 10:15am and was met by the Applicant, Manuel Garcia Brief interview was conducted with the Applicant.
It was learned that this facility will be licensed as an adult residential facility to serve up to 3 ambulatory clients and 1 non-ambulatory client. . This Applicant is also seeking vendorization from local regional center. There were no clients present during today's pre-licensing visit.

Tour of the facility was conducted. Dining area, living area, and all other areas intended for resident use were toured and observed to be furnished and maintained in compliance at this time. LPA observed no obstruction of emergency exits. Fire extinguisher in place at kitchen area and fully charged with last inspection date of 2/4/2025. Facility map indicating emergency exits posted in appropriate locations. Complaint poster and resident rights posted. Kitchen area was toured. Cabinets and drawers were opened and reviewed by this LPA along with the Applicant. Food supply was sufficient in quantities. Medication cabinet, located in the living room area was toured. First aid kit was observed to be present and contained all required components at this time. A tour of the resident bedrooms was conducted. Furnishings and furniture intended for use by the clients were observed to be sufficient and able to meet the needs of the clients at this time.

A tour of the resident bathrooms was conducted. Hot water temperatures were taken and measured within the allowed range of 105-120 degrees F. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels and linens able to meet the needs of the residents at this time.
A tour of the exterior grounds was conducted.

{Cont. on 809C}
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: TOP VALLEY CARE HOME
FACILITY NUMBER: 392701443
VISIT DATE: 03/11/2025
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A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time. This facility has been found to be in compliance at this time. There were no deficiencies observed during today's Pre-licensing visit.

Component III completed with applicant during visit. Exit Interview conducted with Applicant. A copy of this report was left with the Applicant.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
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