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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 394700016
Report Date: 02/19/2025
Date Signed: 02/19/2025 11:32:58 AM

Document Has Been Signed on 02/19/2025 11:32 AM - 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 INSTEAD SENIOR CAREFACILITY NUMBER:
394700016
ADMINISTRATOR/
DIRECTOR:		GLENDA FELIXFACILITY TYPE:
300
ADDRESS:5713 N.PERSHING AVE SUITE A4TELEPHONE:
(209) 933-9737
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY: CENSUS: DATE:
02/19/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Sarah JoaquinTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of Home Instead Senior Care for a biennial inspection on 2/19/2025. Upon arrival, the HCSB analyst identified himself and was greeted by Sarah Joaquin. 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 designee and informed Sarah that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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