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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 364700153
Report Date: 03/11/2025
Date Signed: 03/11/2025 11:20:28 AM

Document Has Been Signed on 03/11/2025 11:20 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:UNIQUE ADULT DAY HOME CAREFACILITY NUMBER:
364700153
ADMINISTRATOR/
DIRECTOR:		VALERIE MARSHALLFACILITY TYPE:
300
ADDRESS:14628 MAIN ST.TELEPHONE:
(442) 800-5750
CITY:HESPERIASTATE: CAZIP CODE:
92345
CAPACITY: CENSUS: DATE:
03/11/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Valerie Marshall, LicenseeTIME 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, Valerie Marshall. The EA observed the posting of the license and operating business hours. Business operating hours are from 8am-5pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee. Licensee has fingerprint clearance. She states she is currently not an HCA and currently has not been able to hire any HCAs. She is planning to hire at least 5-10 HCAs. The HCO’s business records including document for insurance, bond and worker's comp requirements were also reviewed during the visit.

EA Cong-Huyen found the HCO in compliance and no deficiencies were cited. An exit interview was conducted, a copy of this report (HCS809), was provided to the licensee/HCO representative, Valerie Marshall, via email.

EA also discussed with licensee regarding HCA registry, HCS308, HCS500 training log and TB requirements for future HCAs. EA sent licensee links to the above info via email.
LICENSING EVALUATOR NAME: Jane Cong-Huyen
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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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