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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700131
Report Date: 01/22/2025
Date Signed: 01/22/2025 05:32:22 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/22/2025 05:32 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:FIRSTLIGHT HOME CARE OF SOUTH BAYFACILITY NUMBER:
194700131
ADMINISTRATOR/
DIRECTOR:		ROBERTS, LARRYFACILITY TYPE:
300
ADDRESS:20710 MANHATTAN PL #104TELEPHONE:
(424) 704-5330
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY: CENSUS: DATE:
01/22/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Larry Roberts, Licensee and Salvador Morales and Operations ManagerTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of Firstlight Home Care of South Bay on 1/22/25 for a biennial inspection. Upon arrival, EA was greeted by Operations Manager Salvador Morales. 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 Larry Roberts and Salvador Morales and informed them no deficiencies were found.

EA Chan concluded the visit with an exit interview and provide a copy of this report along with appeal rights to Larry Roberts and Salvador Morales.

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
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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