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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700978
Report Date: 10/06/2025
Date Signed: 10/07/2025 10:26:28 AM

Document Has Been Signed on 10/07/2025 10:26 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:INLAND EMPIRE HOME CARE AGENCYFACILITY NUMBER:
194700978
ADMINISTRATOR/
DIRECTOR:		BARRAQUIO, MARIFE LACSONFACILITY TYPE:
300
ADDRESS:1559 E AMAR RD. STE ITELEPHONE:
(626) 838-7938
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY: 0CENSUS: DATE:
10/06/2025
ClosureUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Enforcement Analyst (EA), Ryan Chan, with the Home Care Services Branch (HCSB) conducted an inspection for the purpose of a closure visit. The HCO license expired on June 6, 2025. The EA walked the premises of 1559 E Amar Rd, Ste I, West Covina, CA to verify any signs of operation. During the inspection, the EA did not observe any visible business advertisements or signage for the HCO and verified there was no presence of an HCO operating at this time. The EA confirmed during today’s visit this HCO is no longer in operation and is closed.
NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2025
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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