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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700285
Report Date: 05/06/2026
Date Signed: 05/06/2026 04:42:50 PM

Document Has Been Signed on 05/06/2026 04:42 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:ANGEL CARE IN HOME HELP OF BEVERLY HILLS, INC.FACILITY NUMBER:
194700285
ADMINISTRATOR/
DIRECTOR:		BANEFSHA KHALIQIFACILITY TYPE:
300
ADDRESS:6303 OWENSMOUTH AVE. 10TH FLTELEPHONE:
(310) 745-8070
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: CENSUS: DATE:
05/06/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Jacqueline Malig - LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Home Care Services Branch (HCSB), Enforcement Analyst (EA) Ryan Chan spoke to licensee Jacqueline Malig to conduct a telephone pre-inspection interview. The licensee is due for a biennial visit and has agreed to a virtual visit with EA. The virtual visit is scheduled for 5/15/26 at 1:00pm via FaceTime.
NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2026
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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