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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700329
Report Date: 11/15/2024
Date Signed: 11/15/2024 03:32:34 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/15/2024 03:32 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:ASAP QUALITY CARE LLCFACILITY NUMBER:
194700329
ADMINISTRATOR/
DIRECTOR:		ARTURO SANTA ANA PABLOFACILITY TYPE:
300
ADDRESS:500 E. CARSON ST., STE. 209TELEPHONE:
(562) 200-9100
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY: CENSUS: DATE:
11/15/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Janice Reina Romero - Care Specialist and Arturo Santa Ana Pablo, OwnerTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of ASAP Quality Care LLC on 11/15/24 for a biennial inspection. Upon arrival, EA identified himself and was greeted by Care Specialist Janice Reina Romero, shortly after the home care organization owner Arturo Santa Ana Pablo arrived. The proper posting of business hours and license was observed. EA was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review, EA discussed the findings of the inspection with the licensee and informed him that home care aides who do not have current tb testing are not to be with clients. EA informed him of the deficiencies found and explained they would be noted on the 809D.

EA Chan concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
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 11/15/2024 03:32 PM - It Cannot Be Edited


Created By: Ryan Chan On 11/15/2024 at 02:30 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

FACILITY NAME: ASAP QUALITY CARE LLC
FACILITY NUMBER: 194700329

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/16/2024
Section Cited
1796.45(c)
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1796.45(c) (c)After...examination...home
care aide whose test for tuberculosis infection is negative shall...undergo an examination at least once every two years. Once...positive test for tuberculosis... 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 records reviewed licensee did not ensure home care aide (S1, S4, S6, and S10) completed tb testing at least once every two years which poses and immediate risk to the health and safety of 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: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/15/2024 03:32 PM - It Cannot Be Edited


Created By: Ryan Chan On 11/15/2024 at 02:56 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

FACILITY NAME: ASAP QUALITY CARE LLC
FACILITY NUMBER: 194700329

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2024
Section Cited
1796.44(a)
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1796.44 (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.
This requirement is not met as evidenced by:
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Based on records reviewed licensee did not ensure home care aides (S1 through S10) received the required initial and/or annual training before placing them with clients which poses a potential risk to the health and safety of 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: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
LIC809 (FAS) - (06/04)
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