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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 364700132
Report Date: 12/17/2025
Date Signed: 12/17/2025 02:10:48 PM

Document Has Been Signed on 12/17/2025 02:10 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:FOREVER WAYS CAREFACILITY NUMBER:
364700132
ADMINISTRATOR/
DIRECTOR:		BERNARDO, EMILEEFACILITY TYPE:
300
ADDRESS:3902 E MARRO PRIVADOTELEPHONE:
(909) 456-9449
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY: CENSUS: DATE:
12/17/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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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 Post licensing visit. The EA met with licensee, Emilee Bernardo. The EA observed the posting of the license and operating business hours. Business operating hours are from 9:00am – 11:00am, Wednesdays

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). 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 licensee, Emilee Barnardo, via email.
NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
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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