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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 074700041
Report Date: 04/17/2025
Date Signed: 04/21/2025 10:06:00 AM

Document Has Been Signed on 04/21/2025 10:06 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:EXCELLENT CARE AT HOME, INC.FACILITY NUMBER:
074700041
ADMINISTRATOR/
DIRECTOR:		FRANCIS OJEDAFACILITY TYPE:
300
ADDRESS:3645 MT DIABLO BLVD STE DTELEPHONE:
(925) 284-1213
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY: CENSUS: DATE:
04/17/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Francis OjedaTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
NARRATIVE
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Enforcement Analyst (EA), Megan Vigil, with the Home Care Services Branch (HCSB) conducted an onsite inspection. The EA met with Licensee, Francis Ojeda

During the inspection, the EA observed the posting of the license, operating business, and verified insurance requirements.

During today’s visit, EA Vigil, found the HCO was not in compliance and deficiencies were cited. An exit interview was conducted, a copy of this report, staff records review report and the appeal rights were provided.
NAME OF LICENSING PROGRAM ANALYST: Megan Vigil
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 04/21/2025 10:06 AM - It Cannot Be Edited


Created By: Megan Vigil On 04/17/2025 at 02:33 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
Although this visit/inspection may have focused on the review of specific licensing requirements, the applicant/licensee must comply with all applicable requirements. The California Department of Social Services retains authority to issue citations or take disciplinary action for any deficiency.


FACILITY NAME: EXCELLENT CARE AT HOME, INC.
FACILITY NUMBER: 074700041

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/21/2025
Section Cited
1796.43
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...(a) Home care organizations that employ
affiliated home care aides shall ensure the affiliatedhome care aides are cleared on the home care aide registry before placing the individual in direct contact with clients...
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Proof of clearance on the Home Care Aide Registry was not documented in the caregiver’s personnel records that were reviewed by HCSB analyst. This poses an immediate health and safety risk to clients in care.
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Type A
04/21/2025
Section Cited
1796.23
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…(a) Each person initiating a background examination to be a registered home care aide shall submit his or her fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision...
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Staff did not complete the finger print process before contact with clients. This poses an immediate health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 04/21/2025 10:06 AM - It Cannot Be Edited


Created By: Megan Vigil On 04/17/2025 at 02:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

HOME CARE ORGANIZATION EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
Although this visit/inspection may have focused on the review of specific licensing requirements, the applicant/licensee must comply with all applicable requirements. The California Department of Social Services retains authority to issue citations or take disciplinary action for any deficiency.


FACILITY NAME: EXCELLENT CARE AT HOME, INC.
FACILITY NUMBER: 074700041

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/24/2025
Section Cited
1796.45
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...(d) After each examination, an affiliated home care aide shall submit, and the home care organization shall keep on file, a certificate from the examining practitioner showing that the affiliated home care aide was examined and found free from active tuberculosis disease…
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TB clearance was not documented in the
caregiver’s personnel records that were reviewed by HCSB analyst. This poses an immediate health and safety risk to clients in care.
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Type B
05/08/2025
Section Cited
1796.44
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(a) A licensee shall ensure that prior to providing home care services, an affiliated home care aide shall complete the training requirements specified in this section.(b) An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client...
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A record of completion of the required training
hours and topics was not documented in the
caregiver’s personnel records that were reviewed by HCSB analyst. This poses a potential health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2025
LIC809 (FAS) - (06/04)
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