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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700576
Report Date: 07/23/2025
Date Signed: 07/23/2025 09:14:55 PM

Document Has Been Signed on 07/23/2025 09:14 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:FOUNTAIN HOMECARE SERVICES, LLCFACILITY NUMBER:
194700576
ADMINISTRATOR/
DIRECTOR:		EBUN AYO ONANUGAFACILITY TYPE:
300
ADDRESS:18305 SHERMAN WAY UNIT 13TELEPHONE:
(818) 975-8187
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY: CENSUS: DATE:
07/23/2025
Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Ebun Ayo Onanuga, AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpose of obtaining signatures and delivering an amended report. The EA met with the Home Care Organization (HCO) representative named above.

A copy of this report and the amended report were provided to the HCO representative named above.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2025
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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