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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700252
Report Date: 10/18/2024
Date Signed: 10/18/2024 10:38:04 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/18/2024 10:38 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:WE CARE FOR SENIORS CAREGIVING SERVICES, INC.FACILITY NUMBER:
304700252
ADMINISTRATOR/
DIRECTOR:		LYNETTE FRANCISCOFACILITY TYPE:
300
ADDRESS:17612 BEACH BLVD., SUITE 7BTELEPHONE:
(714) 369-2408
CITY:HUNTINGTON BEACHSTATE: CAZIP CODE:
92647
CAPACITY: CENSUS: DATE:
10/18/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Dolcemar Tejero, designeeTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
NARRATIVE
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Enforcement Analyst (EA), Mila Quinto arrived at the business office of Right at Home for a biennial inspection. Upon arrival, EA was greeted by a staff and shortly after, Dolcemar Tejero (designee) arrived. The proper posting of business hours and license was observed. The proof of insurance's record was reviewed. The Analyst reviewed the personnel and administrative files.

Based on the file review EA informed the licensee of the deficiency found and explained they would be noted on the 809D.

The analyst provided a copy of the report to the designee via email.

LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2024
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 10/18/2024 10:38 AM - It Cannot Be Edited


Created By: Mila Quinto On 10/18/2024 at 10:24 AM
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: WE CARE FOR SENIORS CAREGIVING SERVICES, INC.
FACILITY NUMBER: 304700252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2024
Section Cited
1796.44(c)
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Training Requirements 1796.44(c)an affiliated home care aid shall complete a minimum of five hours of annual training.
This requirement is not met as evidenced by:
Based on file review, HCA2, HCA3, HCA4, HCA6 and HCA7 did not have complete training hours on file.
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This poses a potential 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: 10/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2024
LIC809 (FAS) - (06/04)
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