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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700016
Report Date: 05/18/2023
Date Signed: 05/18/2023 11:33:10 AM


Document Has Been Signed on 05/18/2023 11:33 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:CARING COMPANIONS AT HOME, INCFACILITY NUMBER:
304700016
ADMINISTRATOR:CATHY SAARIFACILITY TYPE:
300
ADDRESS:881 DOVER DR STE 260TELEPHONE:
(949) 574-0750
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92663
CAPACITY:CENSUS: DATE:
05/18/2023
TYPE OF VISIT:Required - 2 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Christian CastilloTIME COMPLETED:
11:30 AM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Caring Companions at Home on 5/18/2023 for a biennial inspection. Upon arrival, the HCSB analyst identified himself and was greeted by Christian Castillo. 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 Christian and informed the designee that no discrepancies were found.
SUPERVISOR'S NAME: Wendy ScottTELEPHONE: (916) 862-3502
LICENSING EVALUATOR NAME: Ruben PerezTELEPHONE: (916) 704-0127
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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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