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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 434700050
Report Date: 07/02/2025
Date Signed: 07/02/2025 03:40:04 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/02/2025 03:40 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:MAXIM HEALTHCARE SERVICES, INC.FACILITY NUMBER:
434700050
ADMINISTRATOR/
DIRECTOR:		KOWALCZYK, DAVIDFACILITY TYPE:
300
ADDRESS:631 RIVER OAKS PARKWAYTELEPHONE:
(408) 914-9124
CITY:SAN JOSESTATE: CAZIP CODE:
95134
CAPACITY: CENSUS: DATE:
07/02/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Veronica Martinez-Padilla & Daniel MaloneyTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Maxim Healthcare Services Inc. for a biennial inspection on 7/2/25. Upon arrival, the HCSB analyst identified himself and was greeted by Veronica Martinez-Padilla and Daniel Maloney. 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 Designees and informed them that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Ramsey Chimienti
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2025
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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