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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700586
Report Date: 10/29/2025
Date Signed: 10/29/2025 02:39:56 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/29/2025 02:39 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:PERFECT FIT HOME CAREFACILITY NUMBER:
194700586
ADMINISTRATOR/
DIRECTOR:		BERGERFACILITY TYPE:
300
ADDRESS:7819 BERGER AVETELEPHONE:
(310) 800-4438
CITY:PLAYA DEL REYSTATE: CAZIP CODE:
90293
CAPACITY: CENSUS: DATE:
10/29/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Scott FoxTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On October 29, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Perfect Fit Home Care for a biennial inspection.. Upon arrival, the Enforcement Analyst identified herself and was greeted by Designees Scott Fox and Analiza Zarate. 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 Designees. The Analyst informed the representatives named above of the deficiency found and explained it 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: 10/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2025
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 10/29/2025 02:39 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 10/29/2025 at 02:25 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: PERFECT FIT HOME CARE
FACILITY NUMBER: 194700586

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/30/2025
Section Cited
1796.45(c)
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TB TESTING: 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.
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This requirement was not met as evidenced by: During the review of files on 10/29/25, Licensee could not provide at time of inspection proof of negative TB test was obtained at least every 2 years as required for reference #3, #4, #5 and #9,, 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: 10/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2025
LIC809 (FAS) - (06/04)
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