<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 304700418
Report Date: 08/12/2025
Date Signed: 08/12/2025 03:22:32 PM

Document Has Been Signed on 08/12/2025 03:22 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:CALIFORNIA CAREGIVING CENTRALFACILITY NUMBER:
304700418
ADMINISTRATOR/
DIRECTOR:		BELINDA SAPPARIFACILITY TYPE:
300
ADDRESS:23002 VIA PIMIENTOTELEPHONE:
(949) 630-1576
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: CENSUS: DATE:
08/12/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Belinda Sappari, LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Enforcement Analysts (EAs), Mila Quinto and Jane Cong-Huyen, with the Home Care Services Branch (HCSB) conducted an on-site inspection for the purpose of a post licensing. The EAs met with the licensee, Belinda Sappari. EA observed the posting of the license and operating business hours. Business operating hours are from 8:00am am -5:00 pm, Monday thru Friday.

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 Home Care Organization’s (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 1796.45( c ) TB Testing. See HCS809D.

An exit interview was conducted, a copy of this report (HCS809 and HCS 809D), staff records review (HCS 859) and appeal rights were provided to the licensee representative, Belinda Sappari via email.
NAME OF LICENSING PROGRAM ANALYST: Mila Quinto
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 08/12/2025 03:22 PM - It Cannot Be Edited


Created By: Mila Quinto On 08/12/2025 at 02:52 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: CALIFORNIA CAREGIVING CENTRAL
FACILITY NUMBER: 304700418

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2025
Section Cited
1796.45(c)
1
2
3
4
5
6
7
1796.45 TB Testing
(c) After submitting to an examination, an affiliated home care aide whose test for tuberculosis infection is negative shall be required to undergo an examination at least once every two years.
This requirement is not met as evidenced by:
8
9
10
11
12
13
14
Based on file review, staff #1 and #4 did not have a current tb clearance available for review.
This poses a potential health and safety risk for clients inc 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: 08/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2