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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700295
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:01:07 PM

Document Has Been Signed on 02/19/2025 03:01 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:MT CARE GROUP LLC DBA ACTI-KARE RESPONSIVEFACILITY NUMBER:
304700295
ADMINISTRATOR/
DIRECTOR:
BHARDWAJ, TARUNFACILITY TYPE:
300
ADDRESS:25283 CABOT RD SUITE 212TELEPHONE:
(562) 774-7400
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY: CENSUS: DATE:
02/19/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Manish Gandhi, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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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 licensee, Manish Gandhi. The EA observed the posting of the license and operating business hours. Business operating hours are from 8am-5pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status', registry status', Tuberculosis (TB), and required training. The HCO’s business records were also reviewed during the visit including, designee in the absence of the licensee and 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), staff records review (HCS 859) and appeal rights were provided to the licensee, Manish Gandhi via email.
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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