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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701313
Report Date: 10/29/2024
Date Signed: 10/29/2024 03:50:00 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/29/2024 03:50 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:MORNING STAR CARE HOMEFACILITY NUMBER:
502701313
ADMINISTRATOR/
DIRECTOR:
GOREAL, KALVENFACILITY TYPE:
740
ADDRESS:3408 GATEWOOD DRIVETELEPHONE:
(209) 595-8534
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 6CENSUS: 0DATE:
10/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Kalven Goreal TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On 10/29/2024, Licensing Program Analyst (LPA) Arielle Pascua arrived unannounced to this facility to conduct an annual visit. LPA met with Facility Designated Administrator (FDA), Kalven Goreal and explained the purpose of the visit.

Current census was 0. A brief interview with FDA Goreal was conducted.
The administrator has an administrator certificate #6031018740.
It was learned that there are currently no residents residing at the facility at this time. It was also learned that this facility is currently going though major renovations and will not obtain residents until renovations have been finished.

LPA conducted a tour of the facility.
It was observed that there are no other resident's in care.

LPA discussed with FDA Goreal that prior to obtaining another residents in care the Licensee shall contact the LPA to conduct a tour of the facility to ensure that the facility is within compliance and is ready to obtain residents in care.
In addition the following shall be completed:
-Annual fees must be current and up to date.
-No residents will be accepted unless the Department has been notified prior to admission
-A mandatory reinspection must take place prior to accepting any residents
-Licensee will remain available to the Department for contact by phone or email

No deficiencies being cited during today's visit, an exit interview was conducted and a copy of this report was provided to the facility at the end of this visit.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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