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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700070
Report Date: 09/19/2024
Date Signed: 09/19/2024 11:40:42 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/19/2024 11:40 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:BRIGHTSTAR CARE OF HUNTINGTON BEACHFACILITY NUMBER:
304700070
ADMINISTRATOR/
DIRECTOR:		SENARTHAGODA, VISHANIFACILITY TYPE:
300
ADDRESS:16052 BEACH BLVD, STE 160TELEPHONE:
(714) 861-4101
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY: CENSUS: DATE:
09/19/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Lori Kewalram, Owner and Desi Munoz, designeeTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Enforcement Analyst (EA), Mila Quinto arrived at the business office of BrightStar Care for a biennial inspection. Upon arrival, Analyst Quinto was greeted by Lori Kewalram, Ownder and Desi Munoz, Designee. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed.

The Analyst reviewed the personnel and administrative files. Upon completion of the file review the analyst discussed the findings of the inspection with the owner and designee and informed there was no discrepancies found.

The analyst provided a copy of the report to the owner and designee via email.

LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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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