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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700377
Report Date: 06/04/2025
Date Signed: 06/04/2025 11:34:59 AM

Document Has Been Signed on 06/04/2025 11:34 AM - 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:INTERIM HEALTHCARE OF OCEANSIDEFACILITY NUMBER:
374700377
ADMINISTRATOR/
DIRECTOR:		PERALTA. LUISFACILITY TYPE:
300
ADDRESS:3044 INDUSTRY ST STE 104TELEPHONE:
(760) 636-8903
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: CENSUS: DATE:
06/04/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Luis PeraltaTIME VISIT/
INSPECTION COMPLETED:
11:45 PM
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On June 4, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Interim Healthcare of Oceanside for a post licensing inspection. Upon arrival, Analyst Mangina was greeted by Licensee Luis Peralta.

During the inspection, Analyst observed proper posting of License and business hours. The Analyst was shown to an area where the review of personnel and administrative files could be performed. Licensee provided proof of current professional liability, worker's compensation and dishonesty bond. There are no employees and no clients at this time. Analyst reviewed no employee files.

Licensee was reminded that per Statute all employees must have fingerprint clearances and TB tests (initial and every 2 years) and all Home Care Aides must additionally have completed initial training consisting of two (2) hours Orientation and three (3) hours safety training including basic safety precautions, emergency procedures, and infection control prior to working with clients, and annually complete five (5) hours additional training (see Health and Safety Code Section 1796.44(c) for specific topic required), as well as be registered and renewed biennially on the Home Care Aide Registry.

Upon completion of the file review the analyst discussed the findings of the inspection with Licensee and informed the Licensee that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2025
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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