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

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 404700033
Report Date: 08/20/2025
Date Signed: 08/20/2025 09:40:59 PM

Document Has Been Signed on 08/20/2025 09:40 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 MATTERS CAREGIVING 005FACILITY NUMBER:
404700033
ADMINISTRATOR/
DIRECTOR:		ANTHONY PEREZFACILITY TYPE:
300
ADDRESS:102 E BRANCH STREET STE GTELEPHONE:
(805) 931-4154
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY: CENSUS: DATE:
08/20/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Kristi EdwardsTIME VISIT/
INSPECTION COMPLETED:
02:30 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
Enforcement Analyst (EA), Joshua Rarela, with the Home Care Services Branch (HCSB) conducted an onsite inspection for the purpose of a Post Licensing visit. The EA met with Home Care Organization (HCO) representative named above.

During the inspection, the EA observed the posting of the license and operating business hours which show the business operates from Monday through Friday, 9AM-5PM. EA reviewed the personnel records for licensee, staff and Home Care Aides. Furthermore, EA reviewed the HCO’s business records including training agenda, abuse reporting incidents, current designee and insurance requirements.

During today’s visit, EA found the HCO was in compliance and no deficiencies were cited. A copy of this report and staff records review report were provided to the HCO representative.
NAME OF LICENSING PROGRAM ANALYST: Joshua Rarela
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2025
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