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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 014700207
Report Date: 07/06/2026
Date Signed: 07/16/2026 11:35:57 AM

Document Has Been Signed on 07/16/2026 11:35 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:BEULAH HOME CARE LLCFACILITY NUMBER:
014700207
ADMINISTRATOR/
DIRECTOR:
RASHAEL AZAHFACILITY TYPE:
300
ADDRESS:1101 MARINA VILLAGE PKWYSTE201TELEPHONE:
(408) 763-4781
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY: CENSUS: DATE:
07/06/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:53 AM
MET WITH:Theresa CorreiaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Enforcement Analyst (EA) Yolanda Jones-Hankerson contacted designee Theresa Correia Office Manager to schedule an inspection Biennial Visit. Virtual and in-person options were discussed, and the Licensee elected to proceed with a virtual visit. EA explained virtual visit requirements, including camera participation, identification verification, and facility walk-through.

During the conversation, EA reviewed the virtual visit process, including the technology requirements, expectations for participation, and the ability to meet all applicable licensing requirements remotely. The expectations for file review were explained, including the requirement that all records be complete, accessible, legible, and available for review at the time of the visit. Licensing requirements and attendance expectations were also discussed.

 EA confirmed the Licensee’s email and licensed address. The Licensee was instructed an email will be sent to submit requested HCA personnel documents (TB, training, proof of registration, etc.) for selected staff. Microsoft Teams meeting invite was sent for July 27, 2026 at !0:00am.
NAME OF LICENSING PROGRAM ANALYST: Yolanda Hankerson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
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