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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700055
Report Date: 07/19/2023
Date Signed: 07/20/2023 08:49:22 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/20/2023 08:49 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:TLC IN HOME CAREFACILITY NUMBER:
344700055
ADMINISTRATOR:WILLIAMS, ELEANOR CFACILITY TYPE:
300
ADDRESS:901 SUNRISE AVE, SUITE A16TELEPHONE:
(916) 862-4450
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: CENSUS: DATE:
07/19/2023
Required - 2 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Eleanor WilliamsTIME COMPLETED:
04:00 PM
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Home Care Services Bureau (HCSB) analyst Ramsey Chimienti arrived at the business office of TLC IN HOME CARE for a biennial inspection on 7/19/23. Upon arrival, the HCSB analyst identified himself and was greeted by Eleanor Williams. 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 the analyst discussed the findings of the inspection with Eleanor and informed the Licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2023
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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