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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 544700016
Report Date: 01/06/2025
Date Signed: 01/06/2025 03:07:11 PM

Document Has Been Signed on 01/06/2025 03:07 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:FREE AIR LIFE, INC.FACILITY NUMBER:
544700016
ADMINISTRATOR/
DIRECTOR:		BILLIEJEAN NEWLINFACILITY TYPE:
300
ADDRESS:1413 N ALTA AVE.TELEPHONE:
(559) 853-9252
CITY:DINUBASTATE: CAZIP CODE:
93618
CAPACITY: CENSUS: DATE:
01/06/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Carrie Carino TIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of Free Air Life for an initial inspection on 1/6/2025. Upon arrival, the HCSB analyst identified himself and was greeted by Carrie Carino. 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 Carrie that no discrepancies were found.
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2025
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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