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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700345
Report Date: 08/04/2025
Date Signed: 08/04/2025 01:01:10 PM

Document Has Been Signed on 08/04/2025 01:01 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:ASSISTING HANDS DANA POINTFACILITY NUMBER:
304700345
ADMINISTRATOR/
DIRECTOR:		WILLIAM NORTHCOTT,MARSHALLFACILITY TYPE:
300
ADDRESS:27122 PASEO ESPADA STE 903TELEPHONE:
(949) 441-4420
CITY:SAN JUAN CAPISTRANOSTATE: CAZIP CODE:
92675
CAPACITY: CENSUS: DATE:
08/04/2025
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Ruth JohnsonTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On August 4, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Assisting Hands Dana Point for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by owner Ruth Johnson. Analyst Mangina observed the proper posting of License and business hours. 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 they 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: 08/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2025
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 08/04/2025 01:01 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 08/04/2025 at 12:36 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: ASSISTING HANDS DANA POINT
FACILITY NUMBER: 304700345

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/05/2025
Section Cited
1796.44(b)(2)
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TRAINING REQUIREMENTS: 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 requirement was not met as evidenced by: During a review of files on 8/4/25 Licensee was not able to provide proof of completion of 3 of 3 hours entry level training including basic safety precautions, emergency procedures, and infection control for referecne #3 and #9, 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: 08/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2025
LIC809 (FAS) - (06/04)
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