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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 414700123
Report Date: 03/04/2025
Date Signed: 03/04/2025 01:48:03 PM

Document Has Been Signed on 03/04/2025 01:48 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:JLF CALIFORNIA HOME CAREFACILITY NUMBER:
414700123
ADMINISTRATOR/
DIRECTOR:		TU, ALISAFACILITY TYPE:
300
ADDRESS:1616 GORDON ST.TELEPHONE:
(650) 562-0550
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: CENSUS: DATE:
03/04/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Alisa TuTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of JLF California Home Care for an initial inspection on 3/4/2025. Upon arrival, the HCSB analyst identified himself and was greeted by Alisa Tu. 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 Alisa that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2025
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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