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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 564700095
Report Date: 08/07/2023
Date Signed: 08/07/2023 02:40:11 PM

Document Has Been Signed on 08/07/2023 02:40 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:ADORE YOU SCFACILITY NUMBER:
564700095
ADMINISTRATOR:FORTU, JOSEFINAFACILITY TYPE:
300
ADDRESS:3645 SAVIERS RD STE 7TELEPHONE:
(805) 385-0051
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: CENSUS: DATE:
08/07/2023
Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Aaron EdradaTIME COMPLETED:
03:00 PM
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Home Care Services Bureau (HCSB) Associate Government Program Analyst (AGPA) Megan Vigil arrived at the business office of Adore You SC on 8/7/2023 at 2:00pm. Upon arrival, AGPA Vigil identified herself and was greeted by Designee, Aaron Edrada and Licensee, Josefina Fortu. 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 Designee/Licensee and informed the Designee/Licensee that no discrepancies were found.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2023
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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