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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700003
Report Date: 04/10/2025
Date Signed: 04/10/2025 10:48:17 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/10/2025 10:48 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:1 SAINTFACILITY NUMBER:
304700003
ADMINISTRATOR/
DIRECTOR:		JANICE RACHELLE JABONEROFACILITY TYPE:
300
ADDRESS:6 CENTERPOINTE DR STE 700TELEPHONE:
(714) 975-3025
CITY:LA PALMASTATE: CAZIP CODE:
90623
CAPACITY: CENSUS: DATE:
04/10/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Jeremiah Jabonero, designeeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Enforcement Analyst (EA), Mila Quinto with the Home Care Services Branch (HCSB) conducted an on site inspection for the purpose of a biennial visit. The EA met with the designee, Jeremiah Jabonero. The EA observed the posting of the license and operating business hours. Business operating hours are from 3:00pm-5:00pm, Wednesdays and Fridays.

During the inspection, the EA reviewed the HCO’s business records of the insurance requirements.

During today’s visit, EA Quinto found the HCO was in compliance and no deficiencies were cited.

An exit interview was conducted, a copy of this report (HCS809), and appeal rights were provided to the licensee, Jeremiah Jabonero via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2025
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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