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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700011
Report Date: 07/15/2024
Date Signed: 07/15/2024 03:05:30 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/15/2024 03:05 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:EXCEL IN HOME CARE SERVICES, LLCFACILITY NUMBER:
374700011
ADMINISTRATOR/
DIRECTOR:		PAOLO ANGELESFACILITY TYPE:
300
ADDRESS:27780 JEFFERSON AVE STE ATELEPHONE:
(760) 884-6112
CITY:TEMECULASTATE: CAZIP CODE:
92590
CAPACITY: CENSUS: DATE:
07/15/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Paolo AngelesTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On July 15, 2024, Home Care Services Bureau (HCSB) Analyst Adrian Mangina arrived at the business office of Excel In Home Care Services for a Biennial inspection. Upon arrival, the HCSB analyst identified herself and was greeted by Office Manager Lorna Guarin. Licensee Paolo Angeles and Designee Mary Angeles arrived a short time later. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Analyst observed current insurance policies and dishonesty bond. Upon completion of the file review the analyst discussed the findings of the inspection with Licensee Paolo Angeles and informed the Licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2024
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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