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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 414700079
Report Date: 02/09/2022
Date Signed: 02/09/2022 09:53:35 AM

Document Has Been Signed on 02/09/2022 09:53 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
CCLD Regional Office, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:CARE INDEED, INC.FACILITY NUMBER:
414700079
ADMINISTRATOR:DEE BUSTOSFACILITY TYPE:
300
ADDRESS:890 SANTA CRUZ AVE. SUITE BTELEPHONE:
(650) 328-1001
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: CENSUS: DATE:
02/09/2022
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Yadvir KaurTIME COMPLETED:
10:00 AM
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Home Care Services Bureau (HCSB) analyst Ruben Perez arrived at the business office of Care Indeed, Inc on 2/9/2022. Upon arrival, the HCSB analyst identified himself and was greeted by Yadvir Kaur. 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 Yadvir and informed the designee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 02/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/09/2022
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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