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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700388
Report Date: 04/25/2025
Date Signed: 04/28/2025 01:44:50 PM

Document Has Been Signed on 04/28/2025 01:44 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:A PLACE AT HOME - ENCINITASFACILITY NUMBER:
374700388
ADMINISTRATOR/
DIRECTOR:		PEREZ-VAN VALZAH, JOSCELYNFACILITY TYPE:
300
ADDRESS:16885 W BERNARDO DR STE 118TELEPHONE:
(719) 922-5227
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: CENSUS: DATE:
04/25/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Joscelyn Perez-Van ValzahTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On April 28, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the business office of A Place at Home Encinitas for a POst Licenseel inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Licensee Joscelyn Perez-Van Valzah 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. Licensee provided Analyst with proof of valid professional liability policy, worker's compensation, and dishonesty bond. Four employee files were reviewed.

Upon completion of the file review Analyst discussed the findings of the inspection with Ms. Perez-Van Valzah and informed Licensee that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2025
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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