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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700062
Report Date: 03/10/2026
Date Signed: 03/12/2026 02:44:55 PM

Document Has Been Signed on 03/12/2026 02:44 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:HOME INSTEAD SENIOR CAREFACILITY NUMBER:
194700062
ADMINISTRATOR/
DIRECTOR:		DON PIERCEFACILITY TYPE:
300
ADDRESS:5500 E. ATHERTON ST.,STE 216TELEPHONE:
(562) 596-4884
CITY:LONG BEACHSTATE: CAZIP CODE:
90815
CAPACITY: CENSUS: DATE:
03/10/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Samantha RhodesTIME VISIT/
INSPECTION COMPLETED:
12:00 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 18, 2026 at 3PM.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2026
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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