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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700788
Report Date: 09/05/2024
Date Signed: 09/05/2024 09:29:58 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/05/2024 09:29 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:NXT LVL CARE CLINIC LLC DBA NXT LEVEL CAREFACILITY NUMBER:
194700788
ADMINISTRATOR/
DIRECTOR:		LUCY HUERTAFACILITY TYPE:
300
ADDRESS:13047 ARTESIA BLVD, SUITE C200TELEPHONE:
(562) 261-0102
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: CENSUS: DATE:
09/05/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Lucy Huerta, DesigneeTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
NARRATIVE
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Enforcement Analyst (EA), Mila Quinto arrived at the business office of NXT Level Care for a biennial inspection. Upon arrival EA Quinto was greeted by designee, Shellee Amariallas. Lucy Huerta, designee arrived shortly after. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. EA, Quinto reviewed the personnel and administrative files. Upon completion of the file review, EA Quinto discussed the findings of the inspection with the designee and informed there were no discrepancies found.

Enforcement Analyst (EA), Mila Quinto arrived at the business office of NXT Level Care for a biennial inspection. Upon arrival, Analyst Quinto was greeted by designee, Shellee Amarials. Lucy Huerta, designee arrived shortly after. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. The Analyst reviewed the personnel and administrative files. Upon completion of the file review the analyst discussed the findings of the inspection with Licensee and informed the Licensee that no discrepancies were found.

EA Quinto provided a copy of the report to the designee via email.

LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2024
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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