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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 214700021
Report Date: 02/19/2025
Date Signed: 02/19/2025 02:38:14 PM

Document Has Been Signed on 02/19/2025 02:38 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:MARIN SENIOR CARE DBA MARIN HOME CAREFACILITY NUMBER:
214700021
ADMINISTRATOR/
DIRECTOR:		CAROLINE GLASSELLFACILITY TYPE:
300
ADDRESS:1640 TIBURON BLVD STE 16TELEPHONE:
(415) 517-5844
CITY:TIBURONSTATE: CAZIP CODE:
94920
CAPACITY: CENSUS: DATE:
02/19/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee - Laura BelluominiTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of Marin Senior Care dba Marin Home Care for a Two-Year Licensing inspection on February 19, 2025. Upon arrival, the Analyst identified himself and was greeted by licensee Laura Belluomini. The proper posting of business hours and license was observed. The Analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the Analyst discussed the findings of the inspection with the licensee and informed the licensee that no discrepancies were found. A copy of the report was provided with appeal rights. Exit interview was conducted.
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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