<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700252
Report Date: 03/18/2026
Date Signed: 05/22/2026 12:38:22 PM

Document Has Been Signed on 05/22/2026 12:38 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:SYNERGY HOME CARE OF NORTH COUNTYFACILITY NUMBER:
374700252
ADMINISTRATOR/
DIRECTOR:		BUTLER, JEBFACILITY TYPE:
300
ADDRESS:5857 OWENS AVENUE, SUITE 300TELEPHONE:
(760) 990-4289
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: CENSUS: DATE:
03/18/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:30 AM
MET WITH:Jeb ButlerTIME VISIT/
INSPECTION COMPLETED:
08:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Home Care Services Branch (HCSB), Enforcement Analyst (EA) Adrian Mangina
spoke to licensee Jeb Butler to conduct a telephone pre-inspection interview.
The licensee is due for a biennial visit and has agreed to a virtual visit with EA. The
virtual visit is scheduled for March 19th at 1:30 PM via Microsoft Teams.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 1