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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 444700002
Report Date: 09/27/2024
Date Signed: 09/27/2024 11:50:57 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/27/2024 11:50 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:VISITING ANGELS, LIVING ASSISTANCE SERVICESFACILITY NUMBER:
444700002
ADMINISTRATOR/
DIRECTOR:		JEANETTE PAGLIAROFACILITY TYPE:
300
ADDRESS:5274 SCOTTS VALLEY DR, STE 102TELEPHONE:
(831) 430-0616
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY: CENSUS: DATE:
09/27/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Jeanette PagliaroTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Visiting Angels for a biennial inspection on 9/27/24. Upon arrival, the HCSB analyst identified himself and was greeted by Jeanette Pagliaro. 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 Jeanette that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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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