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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700494
Report Date: 04/18/2024
Date Signed: 04/18/2024 04:54:54 PM

Document Has Been Signed on 04/18/2024 04:54 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:SENIOR HELPERSFACILITY NUMBER:
194700494
ADMINISTRATOR/
DIRECTOR:		NATHAN KIRSCHENBAUMFACILITY TYPE:
300
ADDRESS:122 E SANTA CLARA STTELEPHONE:
(562) 843-7792
CITY:ARCADIASTATE: CAZIP CODE:
91006
CAPACITY: CENSUS: DATE:
04/18/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Brenda DuarteTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Senior Helpers on 4/18/2024 for a biennial inspection. Upon arrival, the HCSB analyst identified himself and was greeted by Brenda Duarte. 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 Brenda and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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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