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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700041
Report Date: 04/16/2024
Date Signed: 04/16/2024 09:49:24 AM

Document Has Been Signed on 04/16/2024 09:49 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:AGING ASSISTANT, LLCFACILITY NUMBER:
344700041
ADMINISTRATOR/
DIRECTOR:		SALAZAR, RAQUELFACILITY TYPE:
300
ADDRESS:9578 2ND AVE.TELEPHONE:
(916) 669-9430
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: CENSUS: DATE:
04/16/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Raquel SalazarTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Associate Government Program Analyst (AGPA) Megan Vigil arrived at the business office of Aging Assistant LLC for a required two-year inspection on 4.16.2024 at approximately 9:00am.

Upon arrival, AGPA Vigil identified herself and was greeted by Licensee, Raquel Salazar. 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 AGPA Vigil discussed the findings of the inspection with the Licensee and informed no discrepancies were found. A copy of the report was provided with appeal rights.

LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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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