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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 074700127
Report Date: 04/14/2022
Date Signed: 04/14/2022 01:28:39 PM

Document Has Been Signed on 04/14/2022 01:28 PM - 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
CCLD Regional Office, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:HOMECARE PROFESSIONALS, INC.FACILITY NUMBER:
074700127
ADMINISTRATOR:PAULA CAMPBELLFACILITY TYPE:
300
ADDRESS:3474 BUSKIRK AVE, STE CTELEPHONE:
(415) 528-5140
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: CENSUS: DATE:
04/14/2022
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Paula CampbellTIME COMPLETED:
02:00 PM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Homecare Professionals on 4/14/2022. Upon arrival, the HCSB analyst identified himself and was greeted by Paula Campbell. 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 Paula and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
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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