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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700171
Report Date: 07/24/2026
Date Signed: 07/24/2026 04:23:51 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/24/2026 04:23 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:A TO Z HOME CARE INC.FACILITY NUMBER:
304700171
ADMINISTRATOR/
DIRECTOR:		DELILAH PAG ONGFACILITY TYPE:
300
ADDRESS:155 SERENOTELEPHONE:
7145882619
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: CENSUS: DATE:
07/24/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Delilah Pag Ong, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection. The EA met with the licensee, Delilah Pag Ong. Per virtual tour of the facility, EA observed the posting of the license and operating business hours. Business operating hours are from 9:00am -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.

Based on the file review, EA informed the licensee of the following violations observed and being cited in accordance with Health and Safety Code, 1796.31(a)Home Care Aide Renewal; 1796.45(a) TB Testing; 1796.44(c)Training Requirements; 1796.44(b)(2)Training Requirements. See HCS809D.



An exit interview was conducted, a copy of this report (HCS809 and HCS 809D), staff records review (HCS 859), and appeal rights were provided to the licensee, Delilah Pag Ong via email.
Mila Quinto
DATE: 07/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2026
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 4
Document Has Been Signed on 07/24/2026 04:23 PM - It Cannot Be Edited


Created By: Mila Quinto On 07/24/2026 at 01:21 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: A TO Z HOME CARE INC.
FACILITY NUMBER: 304700171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2026
Section Cited
1796.24(a)(1)
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1796.31 Home Care Aide Renewal (a) To remain on the home care aide registry, a registered home care aide shall renew his or her registration every two years.
This requirement is not met as evidenced by:
Based on file review, HCA#1 and HCA#2 do not have a current HCA registry
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This poses an immediate health and safety code to 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: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2026
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/24/2026 04:23 PM - It Cannot Be Edited


Created By: Mila Quinto On 07/24/2026 at 01:36 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: A TO Z HOME CARE INC.
FACILITY NUMBER: 304700171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2026
Section Cited
1796.45(a)
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1796.45 TB Testing
(a) Affiliated home care aides hired on or after January 1, 2016, shall submit to an examination 90 days prior to employment, or within seven days after employment, to determine that the individual is free of active tuberculosis disease.
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This requirement is not met as evidenced by:
Based on file review, HCA#1 and HCA#2 do not have a tb clearance on file.
This poses an immediate health and safety to 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: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/24/2026 04:23 PM - It Cannot Be Edited


Created By: Mila Quinto On 07/24/2026 at 01:40 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: A TO Z HOME CARE INC.
FACILITY NUMBER: 304700171

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2026
Section Cited
1796.44(c)
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1796.44 Training Requirements
(c) ... an affiliated home care aide shall complete a minimum of five hours of annual training.
This requirement is not met as evidenced by:
Based on file review, HCA#2 and HCA#5 did not have the completed annual training for 2025.
Type A
07/31/2026
Section Cited
1796.44(b)(2)
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1796.44 Training Requirements
(b) An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows:(2) Three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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This requirement is not met as evidenced by: Based on file review, HCA#4 did not have the 3 of 5 hours entry level training.
This poses an immediate health and safety risk to 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: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2026
LIC809 (FAS) - (06/04)
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