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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 564700059
Report Date: 06/24/2026
Date Signed: 06/25/2026 07:47:28 AM

Document Has Been Signed on 06/25/2026 07:47 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:1HEART CAREGIVER SERVICES-THOUSAND OAKSFACILITY NUMBER:
564700059
ADMINISTRATOR/
DIRECTOR:		AZORES, PENELOPEFACILITY TYPE:
300
ADDRESS:3625 E THOUSAND OAKS BLVD #323TELEPHONE:
(818) 334-9473
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91362
CAPACITY: CENSUS: DATE:
06/24/2026
OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Penelope Azores - DesigneeTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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Home Care Services Branch (HCSB), Enforcement Analyst (EA) Ryan Chan spoke to designee Penelope Azores to conduct a telephone pre-inspection interview. The home care organization is due for a biennial visit, designee has agreed to a virtual visit with EA. The virtual visit is scheduled for 7/8/26 at 2:00 pm via FaceTime.
NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2026
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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