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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 194701157
Report Date: 04/22/2026
Date Signed: 04/22/2026 03:45:59 PM

Document Has Been Signed on 04/22/2026 03:45 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:1HEART CAREGIVER SERVICE GLENDALEFACILITY NUMBER:
194701157
ADMINISTRATOR/
DIRECTOR:		SANJAY SHARMAFACILITY TYPE:
300
ADDRESS:127 S BRAND BLVD STE 307TELEPHONE:
(818) 913-8459
CITY:GLENDALESTATE: CAZIP CODE:
91204
CAPACITY: CENSUS: DATE:
04/22/2026
Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Sanjay Sharma - LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 4/22/26, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted a case management visit due to a discovery that one of the home care aides (HCA) was not cleared on the HCA Registry.

Based on records reviewed home care aide S1 was not cleared on the HCA Registry prior to being placed with clients. Licensee advised this HCA was employed with this HCO from 11/20/25 through 1/26/26. EA informed the licensee of the deficiencies found and explained they would be noted on the 809D. EA advised licensee that home care aides who are not cleared on the HCA Registry are not to be with clients.

EA Chan concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.
NAME OF LICENSING PROGRAM ANALYST: Ryan Chan
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
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 04/22/2026 03:46 PM - It Cannot Be Edited


Created By: Ryan Chan On 04/22/2026 at 12:22 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: 1HEART CAREGIVER SERVICE GLENDALE
FACILITY NUMBER: 194701157

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2026
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 requirement is not met as evidenced by:
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Based on records reviewed licensee did not ensure home care aide staff S1 was cleared on the home care aide registry prio to placing S1 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: 04/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/22/2026
LIC809 (FAS) - (06/04)
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