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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 104700014
Report Date: 02/01/2024
Date Signed: 02/01/2024 11:41:36 AM

Document Has Been Signed on 02/01/2024 11:41 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:WELL BEING SENIOR SOLUTIONSFACILITY NUMBER:
104700014
ADMINISTRATOR:RACHELLE DYSONFACILITY TYPE:
300
ADDRESS:55 SHAW AVENUE SUITE 220TELEPHONE:
(559) 432-3737
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: CENSUS: DATE:
02/01/2024
Required - 2 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rachelle DysonTIME COMPLETED:
12:00 PM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Well Being Senior Solutions on 2/1/2024 for a biennial inspection. Upon arrival, the HCSB analyst identified himself and was greeted by Rachelle Dyson. 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 Rachelle and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2024
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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