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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700820
Report Date: 03/02/2022
Date Signed: 03/02/2022 02:38:17 PM

Document Has Been Signed on 03/02/2022 02:38 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
CCLD Regional Office, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:CELESTE ANGEL CARE, LLCFACILITY NUMBER:
194700820
ADMINISTRATOR:BIAZON, TERESITAFACILITY TYPE:
300
ADDRESS:3960 CARPENTER AVE, #204TELEPHONE:
(818) 802-9086
CITY:STUDIO CITYSTATE: CAZIP CODE:
91604
CAPACITY: CENSUS: DATE:
03/02/2022
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Teresita BiazonTIME COMPLETED:
03:30 PM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Celeste Angel Care on 3/2/2022. Upon arrival, the HCSB analyst identified himself and was greeted by Teresita Biazon. 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 Teresita and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2022
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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