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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 044700016
Report Date: 03/30/2026
Date Signed: 03/30/2026 11:24:44 AM

Document Has Been Signed on 03/30/2026 11:24 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:INTERIM HEALTHCARE PERSONAL CARE & SUPPORTFACILITY NUMBER:
044700016
ADMINISTRATOR/
DIRECTOR:		MICHELLE KELLYFACILITY TYPE:
300
ADDRESS:2060 TALBERT DR. #100TELEPHONE:
(530) 899-8777
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: CENSUS: DATE:
03/30/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:07 AM
MET WITH:Michelle KellyTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Enforcement Analyst (EA) Yolanda Jones-Hankerson contacted Licensee Michelle (Shelly) Kelly to schedule an inspection 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 by Thursday April 2, 2026 at 3:00pm. Microsoft Teams meeting invite was sent.
NAME OF LICENSING PROGRAM ANALYST: Yolanda Hankerson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2026
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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