<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700658
Report Date: 06/27/2024
Date Signed: 06/27/2024 02:57:36 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/27/2024 02:57 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:SENIOR HELPERS OF CERRITOSFACILITY NUMBER:
194700658
ADMINISTRATOR/
DIRECTOR:		DARSHANA BHAKTAFACILITY TYPE:
300
ADDRESS:17510 PIONEER BLVD., STE. 205TELEPHONE:
(562) 403-4403
CITY:ARTESIASTATE: CAZIP CODE:
90701
CAPACITY: CENSUS: DATE:
06/27/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Emily Mayorga - Client Care Manager TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Home Care Services Bureau (HCSB) Analyst Ryan Chan arrived at the business office of Senior Helpers of Cerritos on 6/27/24 for a biennial inspection. Upon arrival, the HCSB analyst identified himself and was greeted by Client Care Manager Emily Mayorga. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Owner Darshana Bhakta arrived during the inspection and left before the inspection was completed. Upon completion of the file review the analyst discussed the findings of the inspection with Emily which was that some HCAs did not have at least 5 hours of annual training completed. The analyst informed Emily of the deficiencies found and explained they would be noted on the 809D.

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

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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 2
Document Has Been Signed on 06/27/2024 02:57 PM - It Cannot Be Edited


Created By: Ryan Chan On 06/27/2024 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

FACILITY NAME: SENIOR HELPERS OF CERRITOS
FACILITY NUMBER: 194700658

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/29/2024
Section Cited
1796.44(c)
1
2
3
4
5
6
7
1796.44(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...
8
9
10
11
12
13
14
Based on records reviewed licensee did not ensure that home care aids completed a minimum of 5 hours annual training which poses a potential health and safety risk to clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2