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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 567609958
Report Date: 03/20/2025
Date Signed: 03/20/2025 10:19:52 AM

Document Has Been Signed on 03/20/2025 10:19 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:TREMONT HOME CARE, INC.FACILITY NUMBER:
567609958
ADMINISTRATOR/
DIRECTOR:		GRAHAM, LISAFACILITY TYPE:
735
ADDRESS:6694 TREMONT CIRCLETELEPHONE:
(805) 553-8451
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY: 6CENSUS: DATE:
03/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Brian Balisi attempted to conduct an unannounced required annual at facility. LPA arrived at facility and awaited at the front door, but there was nobody there to greet him.

At approx 09:34am, LPA attempted to call the home , but no answer.

At approx 09:37am, LPA attempted to contact licensee on cell phone. LPA left voicemail

At approx 09:38am, LPA text licensee, but no reply.

At approx 09:56am, LPA attempted to contact licensee on cell phone. LPA left voicemail.

LPA will attempt another visit on a later time.

At approx 10:17am, LPA emailed a copy of this report to licensee.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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