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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700399
Report Date: 07/01/2025
Date Signed: 07/01/2025 03:48:07 PM

Document Has Been Signed on 07/01/2025 03:48 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:ST. ROSE CARE LLCFACILITY NUMBER:
374700399
ADMINISTRATOR/
DIRECTOR:		DENNIS AQUINOFACILITY TYPE:
300
ADDRESS:35252 ORCHARD TRAILTELEPHONE:
(619) 957-6467
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY: CENSUS: DATE:
07/01/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Denise AquinoTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On July 1, 2025 , Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of St Rose Care, LLC. for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Designee Denis Aquino. Analyst Mangina observed the proper posting of business hours and License. The Analyst was provided with an area in which the review of personnel and administrative files could be performed. Designee provided Analyst with proof of current professional liability policy, worker's compensation, and dishonesty bond.

Upon completion of the file review Analyst discussed the findings of the inspection with Designee and informed Designee that no discrepancies were found.

NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2025
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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