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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700492
Report Date: 11/14/2023
Date Signed: 11/27/2023 01:52:30 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/27/2023 01:52 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:BEYOND HOME CAREFACILITY NUMBER:
194700492
ADMINISTRATOR:PAULINE CLOKEFACILITY TYPE:
300
ADDRESS:7462 NORTH FIGUEROA ST # 202TELEPHONE:
(310) 600-8192
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY: CENSUS: DATE:
11/14/2023
Required - 2 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Pauline MinanoTIME COMPLETED:
01:00 PM
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Home Care Services Bureau (HCSB) Associate Government Program Analyst (AGPA) Megan Vigil arrived at the business office of Beyond Home Care located at 225 East Broadway Suite 112 Glendale, Ca 91206 on 11.14.23 at approximately 10:30am. Upon arrival, AGPA Vigil identified herself and was greeted by Licensee, Pauline Minano. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. AGPA Vigil was 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 the Licensee and no discrepancies were found.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2023
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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