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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 554700004
Report Date: 09/12/2024
Date Signed: 09/12/2024 05:07:44 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 09/12/2024 05:07 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:FORTUNE SENIOR ENTERPRISES DBA COMFORT KEEPERSFACILITY NUMBER:
554700004
ADMINISTRATOR/
DIRECTOR:		VINCENT A MAFFEOFACILITY TYPE:
300
ADDRESS:14570 MONO WAY, SUITE GTELEPHONE:
(916) 560-9100
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY: CENSUS: DATE:
09/12/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Vincent MaffeoTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti, arrived at the business office of Comfort Keepers - Sonora for a biennial inspection on 9/12/24. Upon arrival, the HCSB analyst identified himself and was greeted by Vincent Maffeo. 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 License and informed Vincent that no discrepancies were found.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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