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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700265
Report Date: 07/25/2024
Date Signed: 07/25/2024 03:13:30 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/25/2024 03:13 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:DIVINE INTEGRITY INC.FACILITY NUMBER:
194700265
ADMINISTRATOR/
DIRECTOR:		RIKKII WISEFACILITY TYPE:
300
ADDRESS:15549 DEVONSHIRE STREET UNIT 5TELEPHONE:
(877) 332-7007
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY: CENSUS: DATE:
07/25/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Rikkii WiseTIME 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 Divine Integrity Inc on 7/25/24 for a biennial inspection. Upon arrival EA identified himself and was greeted by designee Rikkii Wise. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the analyst discussed the findings of the inspection with designee Rikkii Wise and informed her that no discrepancies were found.

Analyst Chan concluded the visit with an exit interview and provided a copy of this report along with appeal rights.

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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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