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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700195
Report Date: 09/29/2025
Date Signed: 09/29/2025 11:18:27 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/29/2025 11:18 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:SAM'S HOME HEALTH CARE INC.FACILITY NUMBER:
334700195
ADMINISTRATOR/
DIRECTOR:		TODER, SAMANTHAFACILITY TYPE:
300
ADDRESS:35845 CANNON DRTELEPHONE:
(818) 400-0216
CITY:PALM DESERTSTATE: CAZIP CODE:
92211
CAPACITY: CENSUS: DATE:
09/29/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Samantha Wachsberger, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Enforcement Analysts (EAs), Jane Cong-Huyen and Mila Quinto with the Home Care Services Branch (HCSB), conducted an onsite inspection for the purpose of a 2 year required licensing visit. The EA met with licensee, Samantha Wachsberger. The EAs observed the posting of the license and operating business hours. Business operating hours are from 8:00am – 12:00pm, Mondays and Tuesdays.

During the inspection, the EAs reviewed personnel records for licensee and Home Care Aides (HCAs) including fingerprint status, HCA registry status, Tuberculosis (TB), and required training(s). EA also reviewed the HCO’s business records for insurance requirements and document for designee in the absence of the licensee.

EA Cong-Huyen found the HCO in compliance and no deficiencies were cited. An exit interview was conducted, and a copy of this report (HCS809) was provided to the licensee, Samantha Wachsberger , via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2025
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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