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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 364700007
Report Date: 03/20/2026
Date Signed: 03/20/2026 11:55:59 AM

Document Has Been Signed on 03/20/2026 11:55 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:SENIOR HOME CAREGIVERS, INC.FACILITY NUMBER:
364700007
ADMINISTRATOR/
DIRECTOR:		DAVIS, BRIANFACILITY TYPE:
300
ADDRESS:1003 E. COOLEY DR., SUITE 203TELEPHONE:
(909) 867-7787
CITY:COLTONSTATE: CAZIP CODE:
92324
CAPACITY: CENSUS: DATE:
03/20/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Veronica Bucia/Brian DavisTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Home Care Services Branch (HCSB), Enforcement Analyst (EA), Jane Cong-Huyen contacted the HCO and conducted a telephone pre-inspection interview. HCO representative, Veronica Bucio, confirmed HCO Information. The HCO is due for a biennial visit and has agreed to a virtual inspection visit with EA.

The virtual inspection visit is scheduled for Monday 3/23/2026 @ 11:30am via Microsoft Teams. EA emailed the HCO with specific instructions regarding the virtual licensing inspection and the required documentation for the HCO to submit to EA via email before/by 9am on Monday 3/23/26.

The HCO will be receiving this report via email. HCO will send report back to EA as soon as possible or by COB with signature to confirm the virtual inspection visit.

NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2026
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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