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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700344
Report Date: 06/27/2024
Date Signed: 06/27/2024 03:52:48 PM

Document Has Been Signed on 06/27/2024 03:52 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:VISITING ANGELS LA JOLLAFACILITY NUMBER:
374700344
ADMINISTRATOR/
DIRECTOR:		KEVIN VAKILIFACILITY TYPE:
300
ADDRESS:3252 HOLIDAY CT. #223TELEPHONE:
(858) 551-8910
CITY:LA JOLLASTATE: CAZIP CODE:
92037
CAPACITY: CENSUS: DATE:
06/27/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Christine Lamb and Cathi TerryTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On June 27, 2024, Home Care Services Bureau (HCSB) Analyst Adrian Mangina arrived at the business office of Visiting Angels La Jolla for a Biennial inspection. Upon arrival, the HCSB analyst identified herself and was greeted by Christine Lamb, Administration/Scheduling and Cathi Terry, Care Manager. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Analyst observed current insurance policies and dishonesty bond. Upon completion of the file review the analyst discussed the findings of the inspection with Designee Lamb and informed Designee that no discrepancies were found.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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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