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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 314700037
Report Date: 07/16/2025
Date Signed: 07/16/2025 03:46:10 PM

Document Has Been Signed on 07/16/2025 03:46 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:HOME INSTEAD SENIOR CAREFACILITY NUMBER:
314700037
ADMINISTRATOR/
DIRECTOR:		JOSEPH SHAWFACILITY TYPE:
300
ADDRESS:173 PALM AVE.TELEPHONE:
(530) 885-3904
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: CENSUS: DATE:
07/16/2025
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Jossly PalmaTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Home Instead Senior Care for a biennial inspection on 7/16/25. Upon arrival, the HCSB analyst identified himself and was greeted by Joslly Palma. 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 the Designee and informed Jossly that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Ramsey Chimienti
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2025
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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