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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 074700132
Report Date: 10/29/2024
Date Signed: 10/30/2024 10:55:16 AM

Document Has Been Signed on 10/30/2024 10:55 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:EAST BAY PROFESSIONAL CAREGIVERS, LLCFACILITY NUMBER:
074700132
ADMINISTRATOR/
DIRECTOR:		IAN FREDERICK SALALILAFACILITY TYPE:
300
ADDRESS:2611 CHERRY HILLS DRTELEPHONE:
(925) 399-9919
CITY:DISCOVERY BAYSTATE: CAZIP CODE:
94505
CAPACITY: CENSUS: DATE:
10/29/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Ethelle CastroTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Enforcement Analyst (EA), Megan Vigil, with the Home Care Services Branch (HCSB) conducted an onsite inspection. EA Vigil met with Designee, Ethelle Castro.

During the inspection, the EA observed the posting of the license, operating business, and verified insurance requirements. EA Vigil reviewed the personnel records to complete the file review.

During today’s visit, EA Vigil, found the HCO is in compliance and deficiencies were not cited. An exit interview was conducted, a copy of this report, staff records review report and the appeal rights were provided to Designee, Ethelle Castro.

LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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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