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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700413
Report Date: 03/18/2025
Date Signed: 03/18/2025 04:12:40 PM

Document Has Been Signed on 03/18/2025 04:12 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:CONNECT QUALITY CARE LLCFACILITY NUMBER:
304700413
ADMINISTRATOR/
DIRECTOR:		CHRISTOPHER MCCOYFACILITY TYPE:
300
ADDRESS:513 E FIRST ST. OFF 2, STE CTELEPHONE:
(714) 493-6369
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: CENSUS: DATE:
03/18/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:50 PM
MET WITH:Marilyn Morales, DesigneeTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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Enforcement Analyst (EA), 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 designee, Marilyn Morales. The EA observed the posting of the license and operating business hours. Business operating hours are from 9:00 am – 5:00 pm, Monday thru Friday.

During the inspection, the EA reviewed personnel records for licensee, and 1 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, designee in the absence of the license and insurance requirements.

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

An exit interview was conducted, a copy of this report (HCS809), staff records review (HCS 859) and appeal rights were provided to the licensee, Christopher McCoy and designee, Marilyn Morales via email.
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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 03/18/2025 04:12 PM - It Cannot Be Edited


Created By: Mila Quinto On 03/18/2025 at 03:45 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

FACILITY NAME: CONNECT QUALITY CARE LLC
FACILITY NUMBER: 304700413

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/01/2025
Section Cited
1796.42(c)
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1796.52 Inspections and Investigations; Oversight Responsibilities; Abuse Cross-Reporting.
(c) An investigation or inspection conducted by the department pursuant to this chapter may include, but is not limited to, inspection of the books, records, or premises of a home care organization.
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This requirement is not met as evidenced by:
Based on interview with the licensee via phone and file review, out of 7 active HCAs, only 1 file was available for review.
This poses a potential 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: 03/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
LIC809 (FAS) - (06/04)
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