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

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 414700094
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:13:31 AM

Document Has Been Signed on 09/10/2024 11:13 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:CARING AND PAIRINGFACILITY NUMBER:
414700094
ADMINISTRATOR/
DIRECTOR:		RAGOOBEER, JASMINAFACILITY TYPE:
300
ADDRESS:619 IVY DRIVETELEPHONE:
(650) 462-1366
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: CENSUS: DATE:
09/10/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Jasmina RagoobeerTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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 Bureau (HCSB) analyst Ruben Perez arrived at the business office of Caring and Pairing on 9/10/2024. Upon arrival, the HCSB analyst identified himself and was greeted by Jasmina Ragoobeer. 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 Jasmina and informed the licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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