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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194700996
Report Date: 03/05/2025
Date Signed: 03/05/2025 02:46:40 PM

Document Has Been Signed on 03/05/2025 02:46 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:HELPING HANDS RESOURCES LLCFACILITY NUMBER:
194700996
ADMINISTRATOR/
DIRECTOR:		MARIBEL CAPIRALFACILITY TYPE:
300
ADDRESS:14736 E VALLEY BLVD.TELEPHONE:
(626) 500-1516
CITY:LA PUENTESTATE: CAZIP CODE:
91746
CAPACITY: CENSUS: DATE:
03/05/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Monica Lopez - BookeeperTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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Home Care Services Bureau Enforcement Analyst (EA) Ryan Chan arrived at the business office of Helping Hands Resources LLC on 3/5/25 for a post licensing inspection. Upon arrival, EA was greeted by Bookeeper Monica Lopez. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. 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 Ms. Lopez. EA informed Ms. Lopez of the deficiencies found and explained they would be noted on the 809D. Ms. Lopez was advised that home care aides who are not cleared on the home care aide registry can not be placed with clients.

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

LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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 3
Document Has Been Signed on 03/05/2025 02:46 PM - It Cannot Be Edited


Created By: Ryan Chan On 03/05/2025 at 01:53 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: HELPING HANDS RESOURCES LLC
FACILITY NUMBER: 194700996

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/01/2025
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 requirement is not met as evidenced by:
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Based on records reviewed licensee did not ensure home care aides (S2, S6, and S7) were cleared on the home care aide registry before placing them with clients which poses an 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: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 03/05/2025 02:46 PM - It Cannot Be Edited


Created By: Ryan Chan On 03/05/2025 at 02:02 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: HELPING HANDS RESOURCES LLC
FACILITY NUMBER: 194700996

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/01/2025
Section Cited
1796.42 (b)
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1796.42 (b) A home care organization licensee shall do all of the following:
(b) Maintain and abide by a valid workers’ compensation policy covering its affiliated home care aides.
This requirement is not met as evidenced by:
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Based on records reviewed licensee employed 1099 independent contractor workers (S2, S6, and S7).
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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: 03/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
LIC809 (FAS) - (06/04)
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