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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700110
Report Date: 12/17/2025
Date Signed: 12/17/2025 11:48:15 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/17/2025 11:48 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:CRYSTAL VIEW CARE SERVICES, CORP.FACILITY NUMBER:
194700110
ADMINISTRATOR/
DIRECTOR:		LUCIA L TABANIAGFACILITY TYPE:
300
ADDRESS:1040 E WHITTIER BLVD RM 201TELEPHONE:
(562) 704-8614
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY: CENSUS: DATE:
12/17/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH: Zorada Bernos, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB), conducted an on-site inspection for the purpose of a biennial inspection. EA met with the licensee, Zorada Bernos. EA observed the posting of the license and operating business hours. Business operating hours are from 10:00am -4:00pm, Mondays, Wednesdays and Fridays.

During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status', registry status', Tuberculosis (TB), and required training. The HomeCare Organization’s (HCO’s) business records were also reviewed during the visit including the insurance requirements.

Based on the file review, EA informed the licensee of the following violations observed and being cited in accordance with Health and Safety Code; TB Testing 1796.45(c), Training Requirements 1796.44(a). See HCS809D.

An exit interview was conducted, a copy of this report (HCS809 and HCS 809D), staff records review (HCS 859), and Appeal Rights were provided to the licensee, Zorada Bernos via email.

NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
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 12/17/2025 11:48 AM - It Cannot Be Edited


Created By: Mila Quinto On 12/17/2025 at 11:21 AM
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: CRYSTAL VIEW CARE SERVICES, CORP.
FACILITY NUMBER: 194700110

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/24/2025
Section Cited
1796.45(c)
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1796.45 TB Testing (c) After submitting to an examination, an affiliated home care aide whose test for tuberculosis infection is negative shall be required to undergo an examination at least once every two years. Once an affiliated home care aide has a documented positive test for tuberculosis infection that has been followed by an X-ray, the examination is no longer required.
This requirement is not met as evidenced by:
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Based on interview and file review of 5 HCA files did not have current tb clearance on file.
This poses an immediate healt 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: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 12/17/2025 11:48 AM - It Cannot Be Edited


Created By: Mila Quinto On 12/17/2025 at 11:25 AM
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: CRYSTAL VIEW CARE SERVICES, CORP.
FACILITY NUMBER: 194700110

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/31/2025
Section Cited
1796.44(c)
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1796.44 Training Requirements(c) In addition to the requirements in subdivision (b), an affiliated home care aide shall complete a minimum of five hours of annual training. The annual training shall relate to core competencies and be population specific, which shall include, but not be limited to, the following areas:
(1) Clients’ rights and safety.
(2) How to provide for, and respond to, a client’s daily living needs.
(3) How to report, prevent, and detect abuse and neglect.
(4) How to assist a client with personal hygiene and other home care services.
(5) If transportation services are provided, how to safely transport a client.
(d) The entry-level training and annual training described in subdivisions (b) and (c) may be completed through an online training program.
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This requirement is not met as evidenced by:
Based on interview and file review of the 5 HCA files, no annaul training on record.
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: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2025
LIC809 (FAS) - (06/04)
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