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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 494700007
Report Date: 06/01/2026
Date Signed: 06/01/2026 02:23:35 PM

Document Has Been Signed on 06/01/2026 02:23 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:INTERIM HEALTHCARE OF SANTA ROSAFACILITY NUMBER:
494700007
ADMINISTRATOR/
DIRECTOR:
CATHY OLSENFACILITY TYPE:
300
ADDRESS:6528 OAKMONT DRTELEPHONE:
(707) 200-2260
CITY:SANTA ROSASTATE: CAZIP CODE:
95409
CAPACITY: CENSUS: DATE:
06/01/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Cathy OlsenTIME VISIT/
INSPECTION COMPLETED:
01:54 PM
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Enforcement Analyst (EA) Yolanda Jones-Hankerson contacted Licensee Cathy Olsen to schedule an inspection visit. Virtual and in-person options were discussed, and the Licensee elected to proceed with a virtual visit. EA explained virtual visit requirements, including camera participation, identification verification, and facility walk-through.

During the conversation, EA reviewed the virtual visit process, including the technology requirements, expectations for participation, and the ability to meet all applicable licensing requirements remotely. The expectations for file review were explained, including the requirement that all records be complete, accessible, legible, and available for review at the time of the visit. Licensing requirements and attendance expectations were also discussed.

 EA confirmed the Licensee’s email and licensed address. The Licensee was instructed an email will be sent to submit requested HCA personnel documents (TB, training, proof of registration, etc.) for selected staff. Microsoft Teams meeting invite was sent for June 11, 2026 at 1:00pm.
NAME OF LICENSING PROGRAM ANALYST: Yolanda Hankerson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/01/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2026
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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