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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700274
Report Date: 04/25/2024
Date Signed: 04/25/2024 11:36:14 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/25/2024 11:36 AM - 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:NEW EVERLASTING CAREGIVERS INCFACILITY NUMBER:
194700274
ADMINISTRATOR/
DIRECTOR:		MARISONIA C. MAYOFACILITY TYPE:
300
ADDRESS:617 WOODLAND CTTELEPHONE:
6266711055
CITY:DUARTESTATE: CAZIP CODE:
91010
CAPACITY: CENSUS: DATE:
04/25/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Mayo Marisonia, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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Home Care Services Bureau (HCSB) Analysts Mila Quinto and Carmen Odom arrived at the business office of New Everlasting Caregivers Inc. to conduct a biennial inspection. Upon arrival, the HCSB analysts identified themselves and was greeted by the licensee, Mayo Marisonia. 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 analysts discussed the findings of the inspection with Licensee and informed the Licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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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