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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 504700039
Report Date: 11/12/2024
Date Signed: 11/12/2024 05:11:39 PM

Document Has Been Signed on 11/12/2024 05:11 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:JSM CARE INC. DBA NURSE NEXT DOORFACILITY NUMBER:
504700039
ADMINISTRATOR/
DIRECTOR:		KARRHA, SHARANDEEPFACILITY TYPE:
300
ADDRESS:1111 J ST. #M107TELEPHONE:
(209) 756-0948
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY: CENSUS: DATE:
11/12/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Sharan KarrhaTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of Nurse Next Door for an initial inspection on 11/12/2024. Upon arrival, the HCSB analyst identified himself and was greeted by Sharan Karrha. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the analyst discussed the findings of the inspection with the Licensee and informed Sharan that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 11/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/12/2024
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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