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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194701035
Report Date: 10/01/2025
Date Signed: 10/01/2025 07:04:28 PM

Document Has Been Signed on 10/01/2025 07:04 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:AAA T.L.C. HEALTH CARE, INC.FACILITY NUMBER:
194701035
ADMINISTRATOR/
DIRECTOR:		ETHEL G. ARCEOFACILITY TYPE:
300
ADDRESS:16133 VENTURA BLVD. #900TELEPHONE:
(818) 380-6585
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY: CENSUS: DATE:
10/01/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Ethel Arceo, AdministratorTIME 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 purpose of a 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 530PM. 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, staff records review report and appeal rights were provided to the HCO administrator electronically.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/01/2025
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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