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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700041
Report Date: 12/17/2025
Date Signed: 12/17/2025 10:56:04 PM

Document Has Been Signed on 12/17/2025 10:56 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:LIFELINE COMPANION SERVICES, INC.FACILITY NUMBER:
194700041
ADMINISTRATOR/
DIRECTOR:		KIM CABRERAFACILITY TYPE:
300
ADDRESS:3100 WEST BURBANK BLVDSTE104TELEPHONE:
(818) 557-6200
CITY:BURBANKSTATE: CAZIP CODE:
91505
CAPACITY: CENSUS: DATE:
12/17/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Kim McPhee, AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an on-site inspection for the purpose of a Post Licensing visit. The EA met with the Home Care Organization (HCO) administrator named above.

During the inspection, the EA observed the posting of the license and operating business hours which show the business operates from Monday through Friday, 830AM to 530PM. EA reviewed the personnel records for licensee, staff and Home Care Aides. Furthermore, EA reviewed the HCO’s business records including training agenda, abuse reporting incidents, current designee and insurance requirements.

During today’s visit, EA found the HCO was in compliance and no deficiencies were cited. A copy of this report, staff records review reports and appeal rights were provided to the HCO electronically.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
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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