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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700875
Report Date: 09/09/2024
Date Signed: 09/09/2025 06:15:51 PM

Document Has Been Signed on 09/09/2025 06:15 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:1HEART CAREGIVER SERVICESFACILITY NUMBER:
194700875
ADMINISTRATOR/
DIRECTOR:		ABELLA, IVYTTEFACILITY TYPE:
300
ADDRESS:9017 RESEDA BLVD STE 200TELEPHONE:
(818) 300-2767
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: CENSUS: DATE:
09/09/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Ivytte AbellaTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpos Post Licensing visit. The EA met with the Home Care Organization (HCO) administrator named above.

During the inspection, the EA observed the posting of the license and operating business hours which show the business operates from Monday through Friday, 9AM to 5PM. EA reviewed the personnel records for licensee, staff and Home Care Aides. Furthermore, EA reviewed the HCO’s business records including training agenda, abuse reporting incidents, current designee and insurance requirements.

During today’s visit, EA found the HCO was in compliance and no deficiencies were cited. A copy of this report and staff records review report were provided to the HCO administrator electronically.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2024
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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