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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 414700089
Report Date: 05/28/2025
Date Signed: 06/03/2025 06:56:46 AM

Document Has Been Signed on 06/03/2025 06:56 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:FIRSTLIGHT HOME CARE OF THE PENINSULAFACILITY NUMBER:
414700089
ADMINISTRATOR/
DIRECTOR:		CARTERIS, JAMESFACILITY TYPE:
300
ADDRESS:1347 LAUREL ST.TELEPHONE:
(650) 486-1310
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: CENSUS: DATE:
05/28/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Ruby SalcedoTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of Firstlight Home Care Of The Peninsula for a biennial inspection on 5/28/2025. Upon arrival, the HCSB analyst identified himself and was greeted by Ruby Salcedo. 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 Ruby that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Ruben Perez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2025
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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