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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920223
Report Date: 03/13/2025
Date Signed: 03/13/2025 09:25:13 AM

Document Has Been Signed on 03/13/2025 09:25 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CARING HEART RESIDENTIALFACILITY NUMBER:
315920223
ADMINISTRATOR/
DIRECTOR:		ABUREKHANLEN, ELOMENSEFACILITY TYPE:
740
ADDRESS:4032 NEWMARKET ST.TELEPHONE:
(916) 841-5941
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6CENSUS: 0DATE:
03/13/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Elomense Aburekhanlen, AdministratorTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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Licensing Program Analyst (LPA) Cassandra Mikkelson arrived at the facility and met with Administrator to conduct a secondary Pre- Licensing visit.

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. Hot water temperature was observed to be 113.3 degrees F. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home.

Component III was completed on March 11, 2025. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.

SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cassandra Mikkelson
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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