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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701268
Report Date: 05/25/2023
Date Signed: 05/26/2023 01:00:27 PM


Document Has Been Signed on 05/26/2023 01:00 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 AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:HOPE CARING HOMEFACILITY NUMBER:
502701268
ADMINISTRATOR:BIRRING, MANJEETFACILITY TYPE:
740
ADDRESS:6703 VARNI WAYTELEPHONE:
(209) 743-2550
CITY:HUGHSONSTATE: CAZIP CODE:
95326
CAPACITY:6CENSUS: 0DATE:
05/25/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Manjeet BirringTIME COMPLETED:
01:15 PM
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On 5/25/23 Licensing Program Analyst (LPA) Kimberly Viarella and Licensing Program Manager (LPM) Liza King made a pre-licensing inspection to this facility. LPA was met by Licensee, Manjeet Birring, (Administrator's Certificate 6065211740, expiration date 01/19/2025). LPA explained the purpose of the visit and a brief interview followed. There were no residents in care at this time.
The LPA inspected the kitchen, dining room, common areas, 2 bathrooms, 4 bedrooms, linen closet, storage closet, garage and the exterior of the house. LPA observed a sufficient amount of furniture, furnishings and lighting to be in compliance. Bathrooms had grab bars, bath mats, paper towels and soap dispensers. There was a sufficient amount of linens for future residents in care.

The kitchen had locked cabinets for sharps, medications and toxins along with a mini-fridge for any future medications that must be refrigerated.

LPA observed that the facility supplied games, magazines, and had a sitting area in the backyard for future residents to enjoy.

LPA observed a new fire extinguisher with a receipt from Walmart dated 05/25/23.
LPA tested all smoke / carbon monoxide detectors.

LPA reviewed Plan of Operation, Disaster Plan and Facility Sketch to ensure it matched those submitted to Community Care Licensing.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Kimberly ViarellaTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/25/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: HOPE CARING HOME
FACILITY NUMBER: 502701268
VISIT DATE: 05/25/2023
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Comp 2 was completed with Licensee.

Facility passed the pre-licensing inspection. California Applications Bureau will be notified within 24 hours.

Exit interview.

Report provided.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Kimberly ViarellaTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023
LIC809 (FAS) - (06/04)
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