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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700163
Report Date: 04/03/2026
Date Signed: 04/03/2026 01:21:55 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/03/2026 01:21 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:ROCKIN' OLDIES II CORP DBA HOME INSTEADFACILITY NUMBER:
194700163
ADMINISTRATOR/
DIRECTOR:
CHITA HENNINGFACILITY TYPE:
300
ADDRESS:5950 CANOGA AVENUE, STE 210TELEPHONE:
(818) 717-0643
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: CENSUS: DATE:
04/03/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Vivialyn Damo - LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Enforcement Analyst (EA), Ryan Chan, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection, EA met with licensee Vivialyn Damo. The proper posting of business hours and license was observed during the virtual tour of the facility.

During the inspection, EA reviewed personnel records for Home Care Aides (HCA) including fingerprint status', registry status', tuberculosis (TB), and required training. The Home Care Organization’s (HCO’s) business records were also reviewed during the visit including the insurance requirements. During today’s visit, EA found the HCO was in compliance and no deficiencies were cited.

An exit interview was conducted and a copy of this report was provided to the licensee via email.

NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2026
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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