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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700922
Report Date: 06/13/2025
Date Signed: 06/13/2025 11:52:52 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/13/2025 11:52 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:JJ FAMILY CARE SERVICESFACILITY NUMBER:
194700922
ADMINISTRATOR/
DIRECTOR:		HASS, ALBERTFACILITY TYPE:
300
ADDRESS:2100 HUNTINGTON DR., STE 1TELEPHONE:
(626) 234-2144
CITY:SAN MARINOSTATE: CAZIP CODE:
91108
CAPACITY: CENSUS: DATE:
06/13/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Cheryl Haas - LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of JJ Family Care Services on 6/13/25 for a biennial inspection. EA met with licensee Cheryl Haas. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. EA was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review EA discussed the findings of the inspection with the licensee and informed her that no discrepancies were found.

EA Chan concluded the visit with an exit interview and provided a copy of this report to the licensee.

NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2025
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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