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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700255
Report Date: 07/15/2026
Date Signed: 07/15/2026 02:31:46 PM

Document Has Been Signed on 07/15/2026 02:31 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:GENKI HOME CAREFACILITY NUMBER:
374700255
ADMINISTRATOR/
DIRECTOR:		KANEKO, EUGENEFACILITY TYPE:
300
ADDRESS:1260 THIRD AVETELEPHONE:
(858) 699-7020
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: CENSUS: DATE:
07/15/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Derek YaguraTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Enforcement Analyst (EA), Adrian Mangina, with the Home Care Services Branch (HCSB) conducted an announced on site visit for the purpose of a biennial inspection. The EA met with the Designee, Derek Yagura. Assistant Manager Naoko Yasukochi During tour of the facility, EA observed the posting of the license and business hours. Business operating hours are 9:30 am - 5:00 pm Monday through 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 Designee,, Derek Yagura, via email.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2026
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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