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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700065
Report Date: 08/27/2025
Date Signed: 08/27/2025 10:27:28 AM

Document Has Been Signed on 08/27/2025 10:27 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:CERNA HOME CAREFACILITY NUMBER:
304700065
ADMINISTRATOR/
DIRECTOR:		PAYZANT, NICKFACILITY TYPE:
300
ADDRESS:2151 MICHELSON DR. # 225TELEPHONE:
(949) 298-3200
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY: CENSUS: DATE:
08/27/2025
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Nick Payzant, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB) conducted an on-site inspection for the purpose of a biennial inspection. The EA met with the licensee, Nick Payzant. EA observed the posting of the license and operating business hours. Business operating hours are from 9:00am am -5:00 pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status', registry status', Tuberculosis (TB), and required training. The Home Care Organization’s (HCO’s) business records were also reviewed during the visit including, the insurance requirements.

During today’s visit, EA Quinto found the HCO was in compliance and no deficiencies were cited.

An exit interview was conducted, a copy of this report (HCS809), staff records review (HCS 859) and appeal rights were provided to the licensee, Nick Payzant via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2025
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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