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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700246
Report Date: 02/05/2024
Date Signed: 02/05/2024 01:05:39 PM

Document Has Been Signed on 02/05/2024 01:05 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:INFINITE LOVE HOMECARE, LLC.FACILITY NUMBER:
304700246
ADMINISTRATOR:JED MARC ADOLFOFACILITY TYPE:
300
ADDRESS:333 CITY BLVD W, STE 1700TELEPHONE:
(949) 416-0500
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY: CENSUS: DATE:
02/05/2024
Required - 2 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Giannina Adolfo
TIME COMPLETED:
01:00 PM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Infinite Love Homecare on 2/5/2024 for a biennial inspection. Upon arrival, the HCSB analyst identified himself and was greeted by Giannina Adolfo. 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 Giannina and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2024
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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