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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701608
Report Date: 10/08/2025
Date Signed: 10/15/2025 06:35:51 AM

Document Has Been Signed on 10/15/2025 06:35 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ASARA SENIOR CAREFACILITY NUMBER:
502701608
ADMINISTRATOR/
DIRECTOR:		JASRAJ BHATIAFACILITY TYPE:
740
ADDRESS:431 W J STREETTELEPHONE:
(209) 566-8080
CITY:OAKDALESTATE: CAZIP CODE:
95361
CAPACITY: 15CENSUS: 0DATE:
10/08/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Jasrah Bhatia, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On 10/8/2025 at 10:00 AM, Licensing Program Analysts (LPA) Triel Ellen Lindstrom arrived at the facility for an announced pre-licensing inspection. The LPA was greeted by the licensee listed on the LIC200 application. The LPA introduced herself, explained the purpose of the visit, and an interview followed. The applicant accompanied the LPA on a tour of the facility.

This facility is an eight-bedroom residential house with three full bedrooms and one half-bathroom. The facility has been cleared for fourteen ambulatory residents and one bedridden resident by the Modesto Fire Department. The City of Oakdale has made the determination that the facility may accommodate ten non-ambulatory bedridden residents and five ambulatory/non-ambulatory residents. The licensee will work with the Department to change the capacity.

The LPA toured the inside of the house, including eight resident bedrooms, three full bathrooms, one half bathroom, kitchen, dining room, living room, two storage rooms, laundry room, and medication room. The entire house was clean, odor-free, and pest-free. Seven bedrooms were double-occupancy, and one bedroom was single occupancy. One bedroom had a half-bathroom. Each bedroom had the required furniture and closet space for personal belongings, and an exit to the outside. The windows and window screens were in good repair. The bathrooms had grab bars and non-slip flooring in the showers. The water temperature at the bathroom sink was 105 degrees Fahrenheit, within the required range of 105-120 degrees Fahrenheit.

The LPA toured the kitchen. There was a two-day supply of perishable food and seven-day supply of non-perishable food. There were enough dishes and cutlery for residents. There was a trash can with a lid.

(Continued on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Lisa Rios
NAME OF LICENSING PROGRAM ANALYST: Ellen Lindstrom
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ASARA SENIOR CARE
FACILITY NUMBER: 502701608
VISIT DATE: 10/08/2025
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The LPA observed that the temperature in the house was set at 75 degrees Fahrenheit. There were two carbon monoxide detectors in the common areas that were in working order. There was a smoke detector in each bedroom, plus three in the common areas, which were interconnected and in working order. There was a sprinkler system that was serviced by Jorgensen Co. in June 2025 and five fire extinguishers that were serviced by Jorgensen Co. on 7/21/2025. The thermostat was set at 75 degrees Fahrenheit.

The LPA observed the medication room, which contained resident-to-be files and the medication cart. The medication room door was locked, the medication cart was locked, and a drawer within the cart which will be used for narcotics had a lock. The dining room and living rooms have seating for residents. The laundry room was locked and contained a locked cabinet for cleaners. There were two storage rooms, one for non-perishable food and one for linens and supplies. The required facility documents were posted in a public place.

The LPA toured the facility grounds. There was a large, shaded activity area with seating on the side of the house. The entire property is enclosed with a fence. The grounds were maintained, with fruit trees in front and potted plants on the side. All walkways were free of obstruction. Both the main door in front and the main door on the side of the house had ramps leading up to them. There were two large sheds that were used for storage at the back of the facility.

The inspection tool was used during this site visit. The LPA completed a Comp III with the Licensee.

As a result of this inspection, the facility was in compliance with California Code of Regulations (CCR), Title 22, Division 6. Pre-Licensing is complete, and this facility has no deficiencies.

An exit interview was conducted with the applicant, to whom a copy of this LIC809 report was provided. Their signature below confirms receipt of this document.

NAME OF LICENSING PROGRAM MANAGER: Lisa Rios
NAME OF LICENSING PROGRAM ANALYST: Ellen Lindstrom
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC809 (FAS) - (06/04)
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