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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 504700005
Report Date: 03/03/2026
Date Signed: 03/12/2026 04:22:04 PM

Document Has Been Signed on 03/12/2026 04:22 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:PROVIDENT CARE, INC.FACILITY NUMBER:
504700005
ADMINISTRATOR/
DIRECTOR:		ROBIN CONLEYFACILITY TYPE:
300
ADDRESS:915 14TH STREETTELEPHONE:
(209) 578-1210
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: CENSUS: DATE:
03/03/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Robin ConleyTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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Enforcement Analyst (EA) Yolanda Jones-Hankerson contacted Licensee Robin Conley and Jessica Keefe to schedule an inspection visit. Virtual and in-person options were discussed, and the Licensee elected to proceed with a virtual visit. EA explained virtual visit requirements, including camera participation, identification verification, and facility walk-through. EA confirmed the Licensee’s email and licensed address. The Licensee was instructed  an email will be sent to submit requested HCA personnel documents (TB, training, proof of registration, etc.) for selected staff by March 13, 2026 at 9am. Microsoft Teams meeting invite was sent.
NAME OF LICENSING PROGRAM ANALYST: Yolanda Hankerson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
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