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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700096
Report Date: 08/20/2024
Date Signed: 08/20/2024 11:33:59 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/20/2024 11:33 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:SEACREST AT HOMEFACILITY NUMBER:
374700096
ADMINISTRATOR/
DIRECTOR:		M. KELLI DENTONFACILITY TYPE:
300
ADDRESS:211 SAXONY RD SUITE 1TELEPHONE:
(760) 942-2695
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: CENSUS: DATE:
08/20/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Kelli DentonTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the business office of Seacrest at Home for a Biennial inspection on August 20, 2024. Upon arrival, the Enforcement Analyst identified herself and was greeted by Director of Homecare, Kelli Denton. Home Care Manager Martin Perez arrived at approximately 11:15 AM. Analyst Mangina observed the proper posting of business hours and license. The analyst was provided an area in which to the review of personnel and administrative file.. Designee Denton provided Analyst with current Certificate of Insurance showing that professional liability policy, worker's compensation, and dishonesty bond are current. Employee files were reviewed. Upon completion of the file review Analyst discussed the findings of the inspection with Designee Kelli Denton and Martin Perez informed the Designees that no discrepancies were found.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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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