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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700364
Report Date: 05/13/2026
Date Signed: 05/14/2026 10:18:52 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 05/14/2026 10:18 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:JCC HOMECARE SERVICES, INC.FACILITY NUMBER:
194700364
ADMINISTRATOR/
DIRECTOR:		ORLANDO R. CUCUECOFACILITY TYPE:
300
ADDRESS:940 E MAIN ST UNIT 9TELEPHONE:
(626) 576-8205
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: CENSUS: DATE:
05/13/2026
Required - 2 YearANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Orlando Cucueco, LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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Enforcement Analyst (EA), Jane Cong-Huyen, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection. EA met with the licensee, Orlando Cucueco. Per virtual tour of the facility, EA observed the posting of the license and operating business hours. Business operating hours are from 9:00am - 5:00pm, Monday through Friday.

During the inspection, EA reviewed personnel records for Home Care Aides (HCAs) including fingerprint status, HCA registry status, Tuberculosis (TB), and required training(s). EA also reviewed the HCO’s business records for insurance requirements.


Based on information reviewed during today's inspection visit, EA informed the licensee of the deficiencies found and noted on the 809D. An exit interview was conducted, a copy of the reports (HCS809 & HCS809D) and appeal rights were provided to licensee, Orlando Cucueco, via email.

NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2026
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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Document Has Been Signed on 05/14/2026 10:18 AM - It Cannot Be Edited


Created By: Jane Cong-Huyen On 05/13/2026 at 12:28 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: JCC HOMECARE SERVICES, INC.
FACILITY NUMBER: 194700364

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/22/2026
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, licensee did not have the annual training available for review for Staff #1, #2, & #3.
This poses a potenial 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: Jane Cong-Huyen
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2026
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/14/2026 10:18 AM - It Cannot Be Edited


Created By: Jane Cong-Huyen On 05/13/2026 at 12:15 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: JCC HOMECARE SERVICES, INC.
FACILITY NUMBER: 194700364

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/22/2026
Section Cited
1796.43(a)
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1796.43 (a) Home care organizations that employ affiliated home care aides shall ensure the affiliated home care aides are cleared on the home care aide registry before placing the individual in direct contact with clients...
This requiirement is not met as evidenced by:
based on interview and file review, staff #3 does not have current HCA registry.
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: Jane Cong-Huyen
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2026
LIC809 (FAS) - (06/04)
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