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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 314700012
Report Date: 07/27/2023
Date Signed: 07/27/2023 12:52:59 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/27/2023 12:52 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:SYNERGY HOMECAREFACILITY NUMBER:
314700012
ADMINISTRATOR:ENRIQUEZ, TAMMYFACILITY TYPE:
300
ADDRESS:2003-A OPPORTUNITY DR, STE 6TELEPHONE:
(916) 899-5925
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: CENSUS: DATE:
07/27/2023
Required - 2 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Christine SorgmanTIME COMPLETED:
01:00 PM
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Home Care Services Bureau (HCSB) analyst Ramsey Chimienti arrived at the business office of Synergy HomeCare for a biennial inspection on 7/27/23. Upon arrival, the HCSB analyst identified himself and was greeted by Christine Sorgman. 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 Christine and informed the License that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
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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