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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701020
Report Date: 07/20/2023
Date Signed: 07/21/2023 10:36:34 AM

Document Has Been Signed on 07/21/2023 10:36 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 AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:HOPE'S CARE HOMEFACILITY NUMBER:
502701020
ADMINISTRATOR:SOLORIO, GLORIAFACILITY TYPE:
735
ADDRESS:315 LALOMA AVETELEPHONE:
(209) 505-1236
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: 6CENSUS: 3DATE:
07/20/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Gloria SolorioTIME COMPLETED:
11:30 AM
NARRATIVE
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Unannounced post licensing visit made out to this facility on 07/20/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by facility staff person, Vanessa Solorio, who was briefly interviewed. This LPA requested that facility staff person go ahead and contact the facility designated Administrator, Gloria Solorio, to inform her that CCL was present at this time.
The facility designated Administrator, Gloria Solorio, arrived shortly thereafter while this LPA was conducting the post licensing visit. Brief interview was conducted with the facility designated Administrator at this time.
Current census was 3 residents.
Current annual visit was also conducted in conjunction with this post licensing visit.

There were no deficiencies observed or cited during today's post licensing visit.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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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