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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700224
Report Date: 07/08/2025
Date Signed: 07/08/2025 12:05:26 PM

Document Has Been Signed on 07/08/2025 12:05 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:CAREGIVING FOR YOUFACILITY NUMBER:
334700224
ADMINISTRATOR/
DIRECTOR:		PENNI KAITZFACILITY TYPE:
300
ADDRESS:31419 CORDERRO LANETELEPHONE:
(951) 598-6647
CITY:MENIFEESTATE: CAZIP CODE:
92584
CAPACITY: CENSUS: DATE:
07/08/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Penni Kaitz, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Enforcement Analyst (EA), Jane Cong-Huyen with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpose of a Post licensing visit. The EA met with licensee, Penni Kaitz. The EA observed the posting of the license and operating business hours. Business operating hours are from 11am-2pm, Tuesday thru Friday.

During the inspection, the EA reviewed personnel records for licensee including fingerprint clearance, registry status, TB, and required training(s). Licensee stated that at this time, she has no clients at the moment and is in the process of hiring HCAs again. The HCO’s business records including document for designee in the absence of the licensee and insurance requirements were also reviewed during the visit.

EA Cong-Huyen found the HCO in compliance and no deficiencies were cited. An exit interview was conducted, a copy of this report (HCS809) was provided to the licensee, Penni Kaitz, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2025
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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