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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 044700001
Report Date: 03/12/2025
Date Signed: 03/12/2025 11:56:17 AM

Document Has Been Signed on 03/12/2025 11:56 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:HOME INSTEAD SENIOR CAREFACILITY NUMBER:
044700001
ADMINISTRATOR/
DIRECTOR:		NATHAN VAILFACILITY TYPE:
300
ADDRESS:2639 FOREST AVE, SUITE 110TELEPHONE:
(530) 895-6100
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: CENSUS: DATE:
03/12/2025
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Designee - Alisa NewtonTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of Home Instead Senior Care for a Two-Year Licensing inspection on March 12, 2025. Upon arrival, the Analyst identified himself and was greeted by designee Alisa Newton. The proper posting of business hours and license was observed. The Analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the Analyst discussed the findings of the inspection with the designee and informed the designee that no discrepancies were found. A copy of the report was provided with appeal rights. Exit interview was conducted.
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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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