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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920019
Report Date: 07/01/2024
Date Signed: 07/01/2024 03:22:40 PM

Document Has Been Signed on 07/01/2024 03:22 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ARJAN CARE HOMEFACILITY NUMBER:
345920019
ADMINISTRATOR/
DIRECTOR:		BHANDAL, SARVEJEETFACILITY TYPE:
740
ADDRESS:9320 PALMERSON DRIVETELEPHONE:
(916) 494-1481
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 6CENSUS: 3DATE:
07/01/2024
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Administrator- Sarvejeet BhandalTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct an annual required and post licensing visit. LPA met with Administrator Sarvejeet Bhandal and explained the purpose of the visit.

For more information on the post licensing visit, please see LIC809 for Required - 1 Year dated 07/01/24.

No deficiencies cited for the post licensing visit.

Exit interview conducted a copy of the report was left at the facility.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cheyenne Ratajczak
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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