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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 434700102
Report Date: 06/08/2023
Date Signed: 07/11/2023 10:22:05 AM

Document Has Been Signed on 07/11/2023 10:22 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:BOUNDLESS CARE INCFACILITY NUMBER:
434700102
ADMINISTRATOR:ARANDA, VIVIANFACILITY TYPE:
300
ADDRESS:5988 SILVER CREEK VALLEY RDTELEPHONE:
(408) 363-8900
CITY:SAN JOSESTATE: CAZIP CODE:
95138
CAPACITY: CENSUS: DATE:
06/08/2023
Annual/RandomUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:VIvian Aranda
TIME COMPLETED:
01:30 PM
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Home Care Services Bureau (HCSB) Associate Government Program Analyst Megan Vigil arrived at the business office of BOUNDLESS CARE INC located at 5988 SILVER CREEK VALLEY RD SAN JOSE, CA on 6.8.20233.
Upon arrival, the HCSB analyst identified herself and was greeted by Vivian Aranda. 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 Vivian Aranda and informed the Vivian Aranda that no discrepancies were found.

LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2023
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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