<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 384700033
Report Date: 08/05/2024
Date Signed: 08/05/2024 03:02:07 PM

Document Has Been Signed on 08/05/2024 03:02 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:HOME CARE SF LLCFACILITY NUMBER:
384700033
ADMINISTRATOR/
DIRECTOR:		RASMUSSEN, KEVINFACILITY TYPE:
300
ADDRESS:45A DOUGLASS STTELEPHONE:
(415) 795-9005
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94114
CAPACITY: CENSUS: DATE:
08/05/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Licensee - Kevin RasmussenTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Home Care Services Branch (HCSB) Analyst, Todd Borcher, arrived at the business office of Home Care SF LLC for a Two-Year Licensing inspection on August 5, 2024. Upon arrival, the analyst identified himself and was greeted by licensee Kevin Rasmussen. 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: 08/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 1