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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700028
Report Date: 03/25/2024
Date Signed: 04/17/2024 01:21:08 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/17/2024 01:21 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
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:SALUS HOMECAREFACILITY NUMBER:
194700028
ADMINISTRATOR:MARK MORTENSENFACILITY TYPE:
300
ADDRESS:21151 S. WESTERN AVE STE. 207TELEPHONE:
(949) 390-7308
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: CENSUS: DATE:
03/25/2024
Required - 2 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Diana RoblesTIME COMPLETED:
11:30 AM
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Home Care Services Bureau (HCSB) analysts, Ramsey Chimienti, Mila Quinto and Todd Borcher arrived at the business office of Salus Homecare for a biennial inspection on 3/25/24. Upon arrival, the HCSB analysts identified themselves and were greeted by Diana Robles. The proper posting of business hours and license was observed. The analysts were then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the analysts discussed the findings of the inspection with Ms. Robles and informed the Designee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2024
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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