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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700224
Report Date: 06/23/2026
Date Signed: 06/23/2026 04:42:21 PM

Document Has Been Signed on 06/23/2026 04:42 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:
06/23/2026
Annual/RandomANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Penni Kaitz, LicenseeTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Enforcement Analyst (EA), Jane Cong-Huyen, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection. EA met with the licensee, Penni Kaitz. Per virtual tour of the facility, EA observed the posting of the license and operating business hours. Business operating hours are from 11:00am - 2:00pm, Tuesday through Friday.

Licensee stated at this time, she has no staff and only one client that she, herself, provides care for. During the inspection, EA reviewed and discussed what are required to be in the personnel records for 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.

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, Penni Kaitz, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/23/2026
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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