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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700092
Report Date: 02/21/2025
Date Signed: 02/21/2025 02:32:11 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/21/2025 02:32 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:ERA LIFE CARE, LLCFACILITY NUMBER:
194700092
ADMINISTRATOR/
DIRECTOR:		NAOMI RODRIGUEZFACILITY TYPE:
300
ADDRESS:1109 W SAN BERNARDINO RD # 110TELEPHONE:
(800) 861-7996
CITY:COVINASTATE: CAZIP CODE:
91722
CAPACITY: CENSUS: DATE:
02/21/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Raquel Mancillas - Client Care CoordinatorTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of Era Life Care LLC on 2/21/25 for a biennial inpection. Upon arrival, EA was greeted by Client Care Coordinator Raquel Mancillas. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. EA was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review EA discussed the findings of the inspection with Ms. Mancillas and informed her that no discrepancies were found.

EA Chan concluded the visit with an exit interview and provided a copy of this report along with appeal rights to Ms. Mancillas.

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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