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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 344700093
Report Date: 03/13/2025
Date Signed: 03/14/2025 07:58:34 AM

Document Has Been Signed on 03/14/2025 07:58 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:IN-YOUR HOME CARE SERVICES LLCFACILITY NUMBER:
344700093
ADMINISTRATOR/
DIRECTOR:		HELEN DIEGOFACILITY TYPE:
300
ADDRESS:3609 MISSION AVE SUITE JTELEPHONE:
(916) 587-1662
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: CENSUS: DATE:
03/13/2025
Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Eloisa Posadas WorsfoldTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Staff Services Manager I (SSMI) Wendy Scott, and Enforcement Analyst (EA) Megan Vigil, arrived at the Home Care Organization for an unannounced Case Management - Other Visit.

Licensee, Eloisa Posadas Worsfold greeted both SSMI, Scott and EA, Vigil.  The purpose of the visit was to deliver the Order of Immediate Exclusion to the Home Care Organization (HCO) Licensee regarding staff #1.

Licensee confirmed staff #1 last day of employment was 03/03/2025 and they only attended an orientation and shadow for one client. The Order of Immediate Exclusion was reviewed with Licensee. An exit interview was conducted and a copy of this report was provided to the licensee along with the appeal rights.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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