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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700584
Report Date: 11/05/2025
Date Signed: 11/05/2025 11:48:27 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/05/2025 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:A PLACE AT HOMEFACILITY NUMBER:
194700584
ADMINISTRATOR/
DIRECTOR:		PATRICK FRESCHFACILITY TYPE:
300
ADDRESS:723 YARMOUTH ROADTELEPHONE:
(310) 750-6080
CITY:PALOS VERDES ESTATESSTATE: CAZIP CODE:
90274
CAPACITY: CENSUS: DATE:
11/05/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Patrick FreschTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On November 5, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the business office of A Place at Home for a biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Designee Patrick Fresch. Analyst was provided with an area in which the review of personnel and administrative files could be performed. Analyst Mangina observed the proper posting of License and business hours. Designee provided Analyst with proof of valid professional liability policy, worker's compensation, and dishonesty bond.

Upon completion of the file review the analyst discussed the findings of the inspection with Designee. The Analyst informed the representative named above of the deficiencies found and explained they would be noted on the HCS809-D forms. In addition, the Licensee was provided a copy of the HCS9058 Appeal rights form.

NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
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 4
Document Has Been Signed on 11/05/2025 11:48 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 11/05/2025 at 11:16 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: A PLACE AT HOME
FACILITY NUMBER: 194700584

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
1796.43(a)
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EMPLOYEES, VOLUNTEERS, AND AFFILIATED HOME CARE AIDE REQUIREMENTS: 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.
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This requirement was not met as evidenced by: During the review of files emailed to Enforcement Analyst on 11/5/25, Licensee was not able to provide at time of inspection proof that to Reference #7 were affiliated and cleared on the California Home Care Aide registry prior to client contact Home Care Registry clearance, a finding which poses an immediate health and safety risk to persons in care.
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Type A
11/06/2025
Section Cited
1796.44(b)(2)
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TRAINING REQUIREMENTS:(b) An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows: three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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This requirement was not met as evidenced by: A review of files on 10/24/25 found that Licensee was not able to provide proof of completion of required 3 of 5 hours entry-level training including basic safety precautions, emergency procedures, and infections control for Reference #7 a finding which poses an immediate health and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 11/05/2025 11:48 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 11/05/2025 at 11:22 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: A PLACE AT HOME
FACILITY NUMBER: 194700584

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
1796.45(a)
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TB TESTING: Affiliated home care aides hired on or after January 1, 2016, shall submit to an examination 90 days prior to employment, or within seven days after employment, to determine that the individual is free of active tuberculosis disease.
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Licensee will immediately remove all Home Care Aides from client contact who have not provided TB tests or have provided TB tests outside of the required 90 day before or 7 days after hire, including Reference #1, #2, #3, #4, #5, #6, until negative TB test result is obtained and will scan proof of negative test to adrian.mangina@dss.ca.gov no later than 11/12/25. In addition, Licensee acknowledges that they will ensure that in the future all home care aides have submitted and the agency will have on hand proof of negative TB tests within 90 days prior or within 7 days after hire and will have no contact with clients before documentation is received.
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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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 11/05/2025 11:48 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 11/05/2025 at 11:27 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: A PLACE AT HOME
FACILITY NUMBER: 194700584

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/26/2025
Section Cited
1796.44(c)
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TRAINING REQUIREMENTS: 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: Clients’ rights and safety, How to provide for, and respond to, a client’s daily living needs, How to report, prevent, and detect abuse and neglect., How to assist a client with personal hygiene and other home care services, If transportation services are provided, how to safely transport a client.
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This requirement was not met as evidenced by: During the review of files on 11/5/25, Licensee was not able to provide proof that Reference #1, #2, #3, #4, #5, #6 have completed 5 of 5 hours of required hours annual training at time of inspection including: Clients’ rights and safety, How to provide for, and respond to, a client’s daily living needs, How to report, prevent, and detect abuse and neglect, How to assist a client with personal hygiene and other home care service, If transportation services are provided, how to safely transport a client, a finding which poses a potential health and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2025
LIC809 (FAS) - (06/04)
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