<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194701096
Report Date: 02/17/2026
Date Signed: 02/17/2026 01:44:26 PM

Document Has Been Signed on 02/17/2026 01:44 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:SHALOMITE HOME CARE LLCFACILITY NUMBER:
194701096
ADMINISTRATOR/
DIRECTOR:		EMMACULATE FUHFACILITY TYPE:
300
ADDRESS:16928 S ORCHARD AVETELEPHONE:
(424) 391-2011
CITY:GARDENASTATE: CAZIP CODE:
90247
CAPACITY: CENSUS: DATE:
02/17/2026
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Renee Chombeng - LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of Shalomite Home Care LLC on 2/17/26 for a biennial inspection, EA met with licensee Renee Chombeng. This organizaton does not have any clients or home care aides since its inception. EA went over home care aide requirements such as training, tb tests, home care aide registry, and background check for when licensee is able to move forward with her business.

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: 02/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 1