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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 234700001
Report Date: 06/10/2026
Date Signed: 06/10/2026 01:27:14 PM

Document Has Been Signed on 06/10/2026 01:27 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:GOERTZEN CARE DBA ANDERSSON CAREFACILITY NUMBER:
234700001
ADMINISTRATOR/
DIRECTOR:		AARON GOERTZENFACILITY TYPE:
300
ADDRESS:32924 ODOM LANETELEPHONE:
(707) 964-4040
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY: CENSUS: DATE:
06/10/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Aaron GoertzenTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Enforcement Analyst (EA) [Name] conducted a virtual visit and met with the licensee/designee, Aaron Goertzen. During the visit, EA verified the posting of the license, observed the operation of the business, confirmed compliance with insurance requirements, and completed the required personnel file review. All requested documentation was provided and reviewed.

The Home Care Organization (HCO) was found to be in compliance with applicable Health and Safety Code requirements. No deficiencies were cited.

An exit interview was conducted, and copies of 809 Facility Evaluation, 859 Staff Records Review Report, and appeal rights information were provided via email.
NAME OF LICENSING PROGRAM ANALYST: Yolanda Hankerson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2026
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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