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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 364700103
Report Date: 09/24/2025
Date Signed: 09/24/2025 02:35:11 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/24/2025 02:35 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
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:CHRISTIAN HOME CARE REFERRAL AGENCYFACILITY NUMBER:
364700103
ADMINISTRATOR/
DIRECTOR:		BERNADINE ELOPREFACILITY TYPE:
300
ADDRESS:8827 KINGS CANYON STTELEPHONE:
(562) 310-0280
CITY:CHINOSTATE: CAZIP CODE:
91708
CAPACITY: CENSUS: DATE:
09/24/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Rosan Mendoza - DesigneeTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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Enforcement Analyst (EA), Jane Cong-Huyen with the Home Care Services Branch (HCSB), conducted an onsite inspection for the purpose of a 2 year required licensing visit. The EA met with HCO representative, Rosan Mendoza. The EA observed the posting of the license and operating business hours. Business operating hours are from 8:00am – 5:00pm, Monday through Friday.

During the inspection, the EA reviewed personnel records for staff and Home Care Aides (HCAs) including fingerprint status, HCA registry status, Tuberculosis (TB), and required training(s). Designee stated currently HCO only has 1 client at this time and only two staff who works on and off when there are clients. EA also reviewed the HCO’s business records for insurance requirements and document for designee in the absence of the licensee.

EA Cong-Huyen found the HCO in compliance and no deficiencies were cited. An exit interview was conducted, and a copy of this report (HCS809) was provided to the HCO representative, Rosan Mendoza, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2025
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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