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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700310
Report Date: 02/14/2025
Date Signed: 02/14/2025 03:16:32 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/14/2025 03:16 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:SAGE CARE PERSONAL IN HOME SERVICES INCFACILITY NUMBER:
374700310
ADMINISTRATOR/
DIRECTOR:		CHANG, RINAFACILITY TYPE:
300
ADDRESS:6105 PASEO DELICIAS STE 8ATELEPHONE:
(858) 348-7791
CITY:RANCHO SANTA FESTATE: CAZIP CODE:
92067
CAPACITY: CENSUS: DATE:
02/14/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Rina Change and Sherwin VillarTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On February 14, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Sage Care Personal in Home Services Inc. for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Business Clerk, Ruben Ronquillo. Owner Rina Chang and Designee Sherwin Villar arrived a short time later. Analyst Mangina observed the proper posting of business hours and license. Mr. Ronquillo provided Analyst an area in which the review of personnel and administrative files could be performed. Analyst was provided with current Certificate of Insurance showing that professional liability policy, worker's compensation, and dishonesty bond are current. Ten employee files were reviewed.

Upon completion of the file review Analyst discussed the findings of the inspection with Designee Villar and Owner Chang and informed representatives above that no discrepancies were found.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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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