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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700379
Report Date: 01/14/2025
Date Signed: 01/14/2025 04:38:18 PM

Document Has Been Signed on 01/14/2025 04:38 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:CAREWISE HOME CARE SERVICESFACILITY NUMBER:
374700379
ADMINISTRATOR/
DIRECTOR:		HANNAH MOHAMEDFACILITY TYPE:
300
ADDRESS:7561 UNIVERSITY AVETELEPHONE:
(619) 721-5742
CITY:LA MESASTATE: CAZIP CODE:
91942
CAPACITY: CENSUS: DATE:
01/14/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Hannah MohamedTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On January, 14, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Carewise Home Care Services for a Post Licensingl inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Designee Hannah Mohamed. Analyst Mangina observed the proper posting of business hours and license. Analyst was provided an area in which the review of personnel and administrative files could be performed. Designee Mohamed provided Analyst with current Certificate of Insurance showing that professional liability policy, worker's compensation, and dishonesty bond are current. There are no Home Care Aides currently employed and no clients.

Upon completion of the file review Analyst discussed the findings of the inspection with Designee and informed Designee that no discrepancies were found.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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