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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701268
Report Date: 01/09/2024
Date Signed: 01/09/2024 03:49:01 PM


Document Has Been Signed on 01/09/2024 03:49 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: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:
01/09/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Manjeet Birring, AdministratorTIME COMPLETED:
04:39 PM
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On 01/09/24 at 3:30 pm Licensing Program Analyst (LPA) Renee Campbell conducted an unannounced case management inspection to ensure there are no residents in place and to close the license per the LIcensee's request. LPA met with Licensee Manjeet Birring, Administrator and together conducted a tour of the home to ensure no residents are currently in place.

LPA Campbell toured the home with the licensee and confirmed there are no residents currently in placement at the facility. The Licensee confirmed they are voluntarily relinquishing their license and understand that to obtain a license again it would require a new application. LPA Cambpell obtained the copy of the facility license from the licensee.

Per California Code of Regulations, Title 22, there were no deficiencies observed or cited during todays inspection.

LPA thanked the licensee for being a part of our program and for the service provided to our community.

This license will be referred to support staff for closure.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee CampbellTELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2024
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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