<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
502700434
Report Date:
07/18/2024
Date Signed:
07/18/2024 11:02:50 AM
Document Has Been Signed on
07/18/2024 11:02 AM
- 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:
CARING HANDS A RESIDENTIAL FACILITY
FACILITY NUMBER:
502700434
ADMINISTRATOR:
ACEDO, MARIA
FACILITY TYPE:
740
ADDRESS:
524 E UNION AVE
TELEPHONE:
(209) 497-8400
CITY:
MODESTO
STATE:
CA
ZIP CODE:
95356
CAPACITY:
6
CENSUS:
5
DATE:
07/18/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Maria ACedo
TIME COMPLETED:
10:30 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Jensen arrived at facility announced to conduct a pre-licensing inspection as the Licensee is attempting to complete a change in ownership. LPA met with Licensee Maria Acedo and explained the purpose of the visit.
LPA Jensen requested the notice to sell given to the residents. The Licensee advised there was no notice given. A technical violation is being given.
An exit interview was conducted and a copy of this report was provided.
SUPERVISOR'S NAME:
Lisa Rios
TELEPHONE:
(916) 969-9685
LICENSING EVALUATOR NAME:
Maja Jensen
TELEPHONE:
(916) 639-5584
LICENSING EVALUATOR SIGNATURE:
DATE:
07/18/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/18/2024
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
1