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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 364700161
Report Date: 03/18/2025
Date Signed: 03/18/2025 12:24:43 PM

Document Has Been Signed on 03/18/2025 12:24 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:ATC CARE SERVICES LLCFACILITY NUMBER:
364700161
ADMINISTRATOR/
DIRECTOR:		NOEL FAJOTAFACILITY TYPE:
300
ADDRESS:2954 E PENNY LANETELEPHONE:
(626) 678-3959
CITY:ONTARIOSTATE: CAZIP CODE:
91761
CAPACITY: CENSUS: DATE:
03/18/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Noell Fajota, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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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, Noel Fajota. The EA observed the posting of the current license and operating business hours: 9am-5pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee, staff, and HCA staff including fingerprint clearance, HCA Registry, Tuberculosis (TB), and required training. The HCO’s business records including document for designee (HCS308) in the absence of the licensee, insurance, bond and worker's compensation 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, Noel, via email.
LICENSING EVALUATOR NAME: Jane Cong-Huyen
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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