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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920019
Report Date: 11/25/2024
Date Signed: 11/25/2024 10:35:30 AM

Document Has Been Signed on 11/25/2024 10:35 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
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, CA
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: 6DATE:
11/25/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Sarvejeet BhandalTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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Licensing Program Analysts (LPAs) Vincent Moleski and Holly Williams arrived unannounced to conduct a collateral visit. LPAs Moleski and Williams met with facility administrator Sarvejeet Bhandal and explained the purpose of the visit.

LPA Williams interviewed a resident during this visit (R1).

No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Bhandal.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE: DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/25/2024
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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