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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700063
Report Date: 06/03/2026
Date Signed: 06/03/2026 08:52:35 AM

Document Has Been Signed on 06/03/2026 08:52 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:AVENUE MEDICAL EQUIPMENT, INCFACILITY NUMBER:
374700063
ADMINISTRATOR/
DIRECTOR:		MYO TUNFACILITY TYPE:
300
ADDRESS:2515 PIONEER AVE STE 3TELEPHONE:
(760) 978-6060
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY: CENSUS: DATE:
06/03/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Shelby ShortTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
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Enforcement Analyst (EA), Adrian Mangina, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection. The EA met with the licensee, Shelby Short. During virtual tour of the facility, EA observed the posting of the license and operating business hours. Business operating hours are 9:00 am to 3:00 pm Monday to Friday..

During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status', registry status', Tuberculosis (TB), and required training. The Home Care Organization’s (HCO’s) business records were also reviewed during the visit including the insurance requirements.

During today’s visit, EA Mangina found the Home Care Organization (HCO) was in compliance and no deficiencies were cited.

An exit interview was conducted, a copy of this report, Home Care Organization Evaluation Report (HCS809), Appeal Rights (HCS9058), and Review of Staff records (HCS859) were provided to the licensee, Shelby Short via email.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2026
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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