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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700080
Report Date: 04/15/2025
Date Signed: 04/21/2025 09:41:56 AM

Document Has Been Signed on 04/21/2025 09:41 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:ALICE CAREFACILITY NUMBER:
344700080
ADMINISTRATOR/
DIRECTOR:		TOMMASO ESMANECHFACILITY TYPE:
300
ADDRESS:8146 GREENBACK LN #106TELEPHONE:
(916) 292-8820
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: CENSUS: DATE:
04/15/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Allison JepsenTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Enforcement Analyst (EA), Megan Vigil, with the Home Care Services Branch (HCSB) conducted an onsite inspection. EA Vigil met with Designee, Allison Jepsen.

During the inspection, the EA observed the posting of the license, operating business, and verified insurance requirements. EA Vigil, reviewed the personnel records to complete the file review.

During today’s visit, EA Vigil, found the HCO was in compliance and no deficiencies were cited. An exit interview was conducted, a copy of this report, staff records review report and the appeal rights were provided.
NAME OF LICENSING PROGRAM ANALYST: Megan Vigil
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2025
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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