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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700093
Report Date: 01/25/2022
Date Signed: 01/25/2022 03:02:02 PM

Document Has Been Signed on 01/25/2022 03:02 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
CCLD Regional Office, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:IN-YOUR HOME CARE SERVICESFACILITY NUMBER:
344700093
ADMINISTRATOR:BASINAL, LOUFACILITY TYPE:
300
ADDRESS:8153 ELKGROVE BLVD STE 20TELEPHONE:
(916) 548-4409
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 0CENSUS: DATE:
01/25/2022
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Maggie PosadasTIME COMPLETED:
03:30 PM
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Home Care Services Bureau (HCSB) Analyst, Ramsey Chimienti arrived at the business office of IN-YOUR HOME CARE SERVICES LLC on 1/25/2022. Upon arrival, the HCSB analyst identified himself and was greeted by Maggie Posadas. 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 Maggieand informed her that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2022
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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