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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700344
Report Date: 07/15/2025
Date Signed: 07/15/2025 04:38:08 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/15/2025 04:38 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-1 HOMECAREFACILITY NUMBER:
304700344
ADMINISTRATOR/
DIRECTOR:		LANHAM, DAVIDFACILITY TYPE:
300
ADDRESS:12 CALLE CASTILLOTELEPHONE:
(949) 338-4257
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY: CENSUS: DATE:
07/15/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Sheila LanthamTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On July 15, 2025 , Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of A-1 Homecare for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by owner Sheila Lanham Analyst Mangina observed the proper posting of business hours and License The Analyst was provided with an area in which the review of personnel and administrative files could be performed. Owner provided Analyst with proof of current professional liability policy, worker's compensation, and dishonesty bond.

Upon completion of the file review the analyst discussed the findings of the inspection with owner The Analyst informed the representative named above of the deficiency found and explained if would be noted on the HCS809-D form. In addition, the Licensee was provided a copy of the HCS9058 Appeal Rights form.

NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
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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Document Has Been Signed on 07/15/2025 04:38 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 07/15/2025 at 11:35 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
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-1 HOMECARE
FACILITY NUMBER: 304700344

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/16/2025
Section Cited
1796.44(b)(2)
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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: three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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This reuirement was not met as eviecned by: Licensee was not able to provide at time of inspection proof that Reference #1, #2, and #3 completed 3 of 3 hours entry-level training including basic safety precautions, emergency procedures, and infection comntrol a finding which poses an immediate health and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 07/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/15/2025
LIC809 (FAS) - (06/04)
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