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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700394
Report Date: 07/01/2025
Date Signed: 07/01/2025 03:05:19 PM

Document Has Been Signed on 07/01/2025 03:05 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:HOME HELPERS OF ORANGE COASTFACILITY NUMBER:
304700394
ADMINISTRATOR/
DIRECTOR:		DWIGHT BROWNFACILITY TYPE:
300
ADDRESS:23412 MOULTON PKWY, STE 220TELEPHONE:
(818) 968-0992
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY: CENSUS: DATE:
07/01/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Dwight Brown, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Enforcement Analyst (EAs), Mila Quinto, with the Home Care Services Branch (HCSB) conducted an on-site inspection for the purpose of a post licensing visit. The EA met with the licensee, Dwight Brown. The EA observed the posting of the license and operating business hours. Business operating hours are from shows as 24 hours.

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 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 violation observe and being cited in accordance with Health and Safety Code 1796.14b Scope of Requirements for HCAs and 1796.44(c) Training Requirements. See HCS809D.

An exit interview was conducted, a copy of this report (HCS809 and HCS809D), staff records review (HCS 859) and appeal rights were provided to the licensee representative, Dwight Brown via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2025
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 07/01/2025 03:05 PM - It Cannot Be Edited


Created By: Mila Quinto On 07/01/2025 at 02:06 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: HOME HELPERS OF ORANGE COAST
FACILITY NUMBER: 304700394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/09/2025
Section Cited
1796.14(b)
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Scope of Requirements for HCAs
(b) An affiliated home care aide shall be listed on the home care aide registry prior to providing home care services to a client.
This requirement is not met as evidenced by:
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Based on interview and file review, HCAs #2 and #7 is not registered on the home care registratry.
This poses a potential health and safety risk to clients in care.
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Type B
07/09/2025
Section Cited
1796.44(c)
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Training Requirements
(c) In addition to the requirements in subdivision (b), an affiliated home care aide shall complete a minimum of five hours of annual training. The annual training shall relate to core competencies and be population specific...
This requirement is not met as evidenced by:
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Based on interview and file review, HCA 9 did not have training information available for review.

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: 07/01/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2025
LIC809 (FAS) - (06/04)
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