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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 434700063
Report Date: 06/09/2026
Date Signed: 06/09/2026 11:39:53 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/09/2026 11:39 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:SENIOR CARE CONNECTION, INC.FACILITY NUMBER:
434700063
ADMINISTRATOR/
DIRECTOR:		DONNA MARTINEZFACILITY TYPE:
300
ADDRESS:1769 PARK AVE STE 210TELEPHONE:
(408) 261-2896
CITY:SAN JOSESTATE: CAZIP CODE:
95126
CAPACITY: CENSUS: DATE:
06/09/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Donna MartinezTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Enforcement Analyst (EA) Ramsey Chimienti conducted a virtual visit for the purpose of completing the required two-year visit and met with the licensee, Donna Martinez.

During the visit, the EA verified the posting of the license, observed the operation of the business, confirmed compliance with insurance requirements, and completed the required personnel file review. All requested documentation was provided and reviewed.

The Home Care Organization (HCO) was found to be in compliance with applicable Health and Safety Code requirements. No deficiencies were cited. An exit interview was conducted, and a copy of the 809 Facility Evaluation Report was provided via email.

NAME OF LICENSING PROGRAM ANALYST: Ramsey Chimienti
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/09/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2026
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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