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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 384700002
Report Date: 05/13/2024
Date Signed: 05/13/2024 03:27:39 PM

Document Has Been Signed on 05/13/2024 03:27 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:CHAJINEL HOME CARE SERVICESFACILITY NUMBER:
384700002
ADMINISTRATOR/
DIRECTOR:		DANIELA JONGUITUDFACILITY TYPE:
300
ADDRESS:208 CYPRESS AVETELEPHONE:
(650) 741-6107
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: CENSUS: DATE:
05/13/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Licensee - Daniela JonguitudTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of Chajinel Home Care Services for a Two-Year Licensing inspection on May 13, 2024. Upon arrival, the Analyst identified himself and was greeted by Licensee Daniela Jonguitud. 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. Upon completion of the file review the Analyst discussed the findings of the inspection with the Licensee and informed the Licensee that no discrepancies were found. A copy of the report was provided with appeal rights. Exit interview was conducted.
LICENSING EVALUATOR NAME: Todd Borcher
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2024
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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