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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700299
Report Date: 03/13/2026
Date Signed: 03/13/2026 04:02:30 PM

Document Has Been Signed on 03/13/2026 04:02 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:GOLDEN AGE CARE INCFACILITY NUMBER:
374700299
ADMINISTRATOR/
DIRECTOR:		VILLAGOMEZ, HARIMFACILITY TYPE:
300
ADDRESS:1115 TOBIAS DRTELEPHONE:
(619) 755-3854
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: CENSUS: DATE:
03/13/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Harim VillagomezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On March 13, 2026, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina conducted a virtual biennial Inspection via Teams of Golden Age Care Inc. Upon commencement of the inspection the Enforcement Analyst identified herself and displayed employee badge. Analyst was greeted by Designee Harim Villagomez who presented their California Driver’s License. Analyst was provided employee files for review prior to this inspection. During the virtual inspection, Designee walked the premises and allowed Analyst Mangina to observe the proper posting of License and business hours. Analyst also viewed proof of valid professional liability policy, worker's compensation, and dishonesty bond before the inspection.

Upon completion of the file review Analyst discussed the findings of the inspection with Ms. Villagomez and informed Designee that no discrepancies were found. Licensee was provided a copy of this report and the HCS9058 Appeal Rights form via email and will return a signed copy of the report to Analyst upon receipt.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2026
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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