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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700028
Report Date: 03/02/2026
Date Signed: 03/02/2026 03:51:28 PM

Document Has Been Signed on 03/02/2026 03:51 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/
DIRECTOR:		MARK MORTENSENFACILITY TYPE:
300
ADDRESS:21151 S. WESTERN AVE STE. 207TELEPHONE:
(949) 390-7308
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: CENSUS: DATE:
03/02/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Susan GonzalezTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) corresponded with
the Home Care Organization (HCO) representative named above regarding a Biennial inspection. The HCO
opted for a Virtual Biennial inspection.

The Biennial inspection is tentatively scheduled for March 5, 2026 at 1PM.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2026
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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