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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 434700200
Report Date: 01/17/2025
Date Signed: 01/17/2025 01:45:44 PM

Document Has Been Signed on 01/17/2025 01:45 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:NU CAREFACILITY NUMBER:
434700200
ADMINISTRATOR/
DIRECTOR:		H. EDWARD LEEFACILITY TYPE:
300
ADDRESS:1879 LUNDY AVE. #218TELEPHONE:
(888) 862-2003
CITY:SAN JOSESTATE: CAZIP CODE:
95131
CAPACITY: CENSUS: DATE:
01/17/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Ele FernandezTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Nu Care for a post licensing inspection on 1/17/25. Upon arrival, the HCSB analyst identified himself and was greeted by Ele Fernandez. 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 Licensee and informed Ele that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2025
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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