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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701494
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:05:08 PM

Document Has Been Signed on 01/07/2025 12:05 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:MANNAT ASSISTED LIVINGFACILITY NUMBER:
342701494
ADMINISTRATOR/
DIRECTOR:		BHATIA, SIMRANJIT KAURFACILITY TYPE:
740
ADDRESS:12050 COUNTRY GARDEN DRIVETELEPHONE:
(916) 841-9449
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95742
CAPACITY: 6CENSUS: 0DATE:
01/07/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Simranjit Kaur BhatiaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 01/07/25, Licensing Program Analyst (LPA) Kimberly Viarella made an announced visit to this facility to conduct a pre-licensing inspection. LPA identified herself upon arrival and stated the purpose of the visit. LPA met with Licensee/Administrator, Simranjit Bhatia and a brief interview followed.

LPA and Licensee toured and inspected the physical plant inside and outside to ensure there were no health and safety concerns. LPA observed the kitchen area, dining area, bedrooms and bathrooms, storage areas, and laundry room. LPA observed knives/sharps area to be locked. LPA observed required furniture, and lighting throughout the facility. LPA measured the hot water to ensure it was between the required range of 105 and 120 degrees Fahrenheit.

The first aid kit included supplies such as sterile first aid dressings, bandages or roller bandages, adhesive tape, scissors, tweezers, thermometer, and antiseptic solution. LPA observed area for centrally stored medications to be locked. LPA observed the fire extinguisher(s), smoke and carbon monoxide detector(s). Facility also has central heating and air.

LPA reviewed fire clearance and room allocations for ambulatory and non-ambulatory residents.

Component III conducted - There are no objections to licensure at this time. -Licensure pending.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Kimberly Viarella
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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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