304700397-6-30-2025-47-HC-MQUO-DJ5MF4-20250630093340

Community Care Licensing

HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700397
Report Date: 06/27/2025
Date Signed: 06/30/2025 09:34:15 AM

Document Has Been Signed on 06/30/2025 09:34 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:	REAL HELP HOME CARE		FACILITY NUMBER:	304700397
ADMINISTRATOR/ DIRECTOR:	DARRYL COX		FACILITY TYPE:	300
ADDRESS:	555 ANTON BLVD. #200		TELEPHONE:	(310) 689-8764
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92626
CAPACITY:		CENSUS:	DATE:	06/27/2025
	Case Management - Deficiencies	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Darryle Cox, Licensee		TIME VISIT/ INSPECTION COMPLETED:	10:30 AM

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Enforcement Analyst (EA), Mila Quinto, with the Home Care Services Branch (HCSB) conducted a case management report due to discovery from interview with licensee and record review of invoices and daily notes.

According to the licensee, he was not involved on the day-to-day operation after April 9, 2024. The licensee stated Staff 1 (S1) have taken the role as a manager and handled the day to day which included client assessments, billings and ensuring the HCAs had all the requirements.

EA obtained record of invoices and daily notes showing 4 homecare aids (HCAs), including S1 provided care to a client from August 18, 2024, to December 15, 2024. The 2 of 4 HCAs were not registered on the home care registry and did not have a criminal background clearance.

Based on EA’s interview with the licensee and record review, the following violations are being cited in accordance with Health and Safety Code, Division 2, Chapter 13, Section 1796.23 Fingerprint Requirements See HCS 809D.

An exit interview was conducted, and the reports and appeal rights were provided to the licensee, Darryl Cox via email.

NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/27/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

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 06/30/2025 09:34 AM - It Cannot Be Edited

Created By: Mila Quinto On 06/27/2025 at 08:43 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: REAL HELP HOME CARE	FACILITY NUMBER: 304700397
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/27/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/07/2025 Section Cited 1796.23	1 2 3 4 5 6 7	1796.23 Fingerprint Requirements (a) Each person initiating a background examination to be a registered home care aide shall submit their fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision (d). (b) A law enforcement agency or other local agency authorized to take fingerprints may charge a reasonable fee to offset the costs of fingerprinting for the purposes of this chapter. The fee revenues shall be deposited in the Fingerprint Fees Account. (c) The Department of Justice shall use the fingerprints to search state and Federal Bureau of Investigation criminal offender record information pursuant to Section 1522. (d) A person who is a current licensee or employee in a facility licensed by the department, a certified foster parent, a certified administrator, or a registered TrustLine provider need not submit fingerprints to the department, and may transfer their current criminal record clearance or exemption pursuant to paragraph (1) of subdivision (h) of Section 1522. The person shall instead submit to the department, along with the person’s registration application, a copy of the person’s identification card described in Section 1796.22 and sign a declaration verifying the person’s identity. This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on interview with the licensee and record review, S1 did not have a valid fingerprint requirements. This poses an immediate health and safety risk to clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: 06/27/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025

LIC809 (FAS) - (06/04)

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