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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700263
Report Date: 07/16/2025
Date Signed: 07/16/2025 03:56:13 PM

Document Has Been Signed on 07/16/2025 03:56 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:JM CARE STAFFING LLCFACILITY NUMBER:
334700263
ADMINISTRATOR/
DIRECTOR:		MARGARET CHUPA-CHIMIMBAFACILITY TYPE:
300
ADDRESS:26562 JAMES DRTELEPHONE:
(760) 672-0029
CITY:MENIFEESTATE: CAZIP CODE:
92585
CAPACITY: CENSUS: DATE:
07/16/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Joanne Davis - LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:00 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 co-licensee/HCO representative, Joanne Davis. The EA observed the posting of the license and operating business hours. Business operating hours are from 9am-5pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensees including fingerprint status and Tuberculosis (TB). Licensees do not provide care for clients. The HCO is still in the process of starting up the business and has no clients with no active HCAs at this time. 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 HCO representative, Joanne Davis, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
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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