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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700072
Report Date: 05/08/2024
Date Signed: 05/08/2024 12:41:07 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/08/2024 12:41 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:MNT SENIOR SERVICES, INC., DBA VISITING ANGELSFACILITY NUMBER:
194700072
ADMINISTRATOR/
DIRECTOR:		SONIA MENDOZAFACILITY TYPE:
300
ADDRESS:1117 E BROADWAYTELEPHONE:
(818) 549-1400
CITY:GLENDALESTATE: CAZIP CODE:
91205
CAPACITY: CENSUS: DATE:
05/08/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:01 PM
MET WITH:Marine Topchyan, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
NARRATIVE
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On May 8, 2024, Associate Governmental Program Analysts (AGPA) Joshua Rarela and Ryan Chan with
Home Care Services Bureau arrived at the Home Care Organization (HCO) listed above. Upon arrival, the
AGPAs identified themselves and was greeted by the HCO representative named above.

The proper posting of business hours and license were observed. The AGPAs were then shown to an area
where the review of personnel and administrative files could be performed. Upon completion of the file review,
the AGPAs discussed the findings of the inspection with the HCO representative and informed them that no discrepancies were found.
LICENSING EVALUATOR NAME: Joshua Rarela
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2024
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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