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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 484700035
Report Date: 12/18/2024
Date Signed: 12/18/2024 02:17:04 PM

Document Has Been Signed on 12/18/2024 02:17 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:Q & R HOME CARE SERVICES LLCFACILITY NUMBER:
484700035
ADMINISTRATOR/
DIRECTOR:		ROSHAWN S. PEARSONFACILITY TYPE:
300
ADDRESS:2707 WHITE ALDER CT.TELEPHONE:
(707) 344-0344
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: CENSUS: DATE:
12/18/2024
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Roshawn PearsonTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Q & R Home Care Services for an initial inspection on 12/18/24. Upon arrival, the HCSB analyst identified himself and was greeted by Roshawn Pearson. 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 Roshawn that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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