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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 331880898
Report Date: 04/13/2026
Date Signed: 04/13/2026 04:35:33 PM

Document Has Been Signed on 04/13/2026 04:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME:HELPING HANDS CARE HOMESFACILITY NUMBER:
331880898
ADMINISTRATOR/
DIRECTOR:		KINCHERLOW, TYLAFACILITY TYPE:
740
ADDRESS:33999 TUSCAN CREEK WAYTELEPHONE:
(951) 365-0443
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY: 5CENSUS: 6DATE:
04/13/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee Tyla KincherlowTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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On 04/13/2026, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to the facility for a required annual inspection. LPA was greeted and granted entry by Volunteer 1 (V1) who was informed of the purpose of the visit. Licensee Tyla Kincherlow was present in the facility and also informed of the purpose of the visit.

LPA toured the facility with Licensee Kincherlow, conducted interviews, and reviewed records. LPA observed the facility is made up of a one-story home with four (4) resident bedrooms, two (2) bathrooms, a kitchen, dining area, living room, laundry room, and attached garage. Resident bedrooms had the required bedding, furniture, and lighting. Bathroom showers were equipped with grab bars and shower chairs. No bodies of water were observed on the premises. Indoor and outdoor pathways were free of obstruction. The facility met requirements for a two-day supply of perishable foods and seven-day supply of non-perishable foods. Knives and medications are secured in a locked cabinet. LPA observed a hallway closet with additional bath towels, bedding and linens. Licensee tested one (1) of the smoke alarms/carbon monoxide detectors and LPA heard it to be operational. LPA also observed a charged fire extinguisher mounted near the kitchen last serviced on 06/10/2025. LPA conducted a record review which noted the facility's certificate of liability insurance expires on 07/29/2026 and licensee's administrator certificate expires on 09/21/2027. LPA reviewed the facility's Emergency Disaster Drill noting their last emergency drill was conducted on 03/08/2026. Resident files reviewed had updated physician's reports and signed admission agreements. V1 has a valid CPR/first aid certification on file.
NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Janette Romero
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: HELPING HANDS CARE HOMES
FACILITY NUMBER: 331880898
VISIT DATE: 04/13/2026
NARRATIVE
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The facility has an approved fire clearance to serve five (5) non-ambulatory elderly residents, of which one (1) may be bedridden. The facility also has an approved hospice waiver for four (4) residents and LPA was informed only one (1) resident is currently receiving hospice services. Departmental records show the facility is pending approval of a capacity increase request. During today's visit, LPA observed six (6) residents present in the facility. Licensee reported on approximately February 21, 2026, the fire department inspected the facility for the capacity increase request and verbally approved her to house six (6) non-ambulatory elderly residents of which one (1) may be bedridden. However, Community Care Licensing has not received an approved or denied fire clearance regarding the capacity increase request. As a result, the facility is operating over their approved capacity.

LPA reviewed a copy of the facility's sketch received by the Department on 02/05/2026. LPA toured the room currently shared by Resident 1 (R1) and Resident 2 (R2) and observed a mattress in what appeared to be a walk-in closet. Inside the facility, this room is labeled as Room 4, but the facility sketch lists this room as, Bedroom 1 designated for staff. Licensee reported she placed the mattress in the walk-in closet and sleeps there as of approximately two months ago. Licensee will contact with the fire department and inquire whether a new fire clearance inspection is warranted due to the staff room being changed to a resident room. LPA also conducted an interview with V1 and determined they exceed the requirements to be exempt from obtaining a criminal record clearance. Departmental records show V1 has a criminal record clearance but is not associated with the facility. V1 reported volunteering in the facility providing care and supervision to the residents for five (5) hours a day for the past five (5) days. LPA also reviewed Resident 3's (R3's) admission agreement dated 05/23/2023 and found that the facility's visiting policy listed requests visitors to provide a 30 minute notice before arrival and restricts the visitation duration to 1-2 hours depending on whether the bedroom was shared. Licensee reported staff have not restricted R3's visits despite this being documented in their admission agreement. The facility will receive a technical violation regarding this. The facility will be cited and civil penalties will be assessed for the deficiencies noted during today's visit. Licensee was offered a referral to the Department's Technical Support Program which they accepted. An exit interview was conducted and a copy of this report, Confidential Names list (LIC 811), LIC 809-D, LIC 421BG, and Appeal Rights were reviewed and provided to Licensee Kincherlow.

Note - LPA was off site from approximately 12:50 p.m. to 3:30 p.m.
NAME OF LICENSING PROGRAM MANAGER: Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST: Janette Romero
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/13/2026 04:35 PM - It Cannot Be Edited


Created By: Janette Romero On 04/13/2026 at 03:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: HELPING HANDS CARE HOMES
FACILITY NUMBER: 331880898

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87307(a)(2)(D)
87307 Personal Accommodations and Services
(a) Living accommodations and grounds shall be related to the facility's function. The facility shall be large enough to provide comfortable living accommodations and privacy for the residents, staff, and others who may reside in the facility. The following provisions shall apply:
(2) Resident bedrooms shall be provided which meet, at a minimum, the following requirements:
(D) Not more than two residents shall sleep in a bedroom.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee sleeps in the walk-in closet located in R1 and R2's bedroom, which poses a potential health, safety, and personal rights risk to persons in care.
POC Due Date: 04/13/2026
Plan of Correction
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Licensee reported she will remove the bed she placed in R1 and R2's walk-in closet which she uses to sleep in. Plan of correction to be emailed to LPA by close of business on 04/13/2026.
Licensee also agreed to not sleep in any resident room or common area designated for resident use and will obtain a building permit and fire clearance movingforward to make any alterations to the approved facility sketch.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Carolyn Tuba
NAME OF LICENSING PROGRAM MANAGER:
Janette Romero
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/13/2026 04:35 PM - It Cannot Be Edited


Created By: Janette Romero On 04/13/2026 at 03:25 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: HELPING HANDS CARE HOMES
FACILITY NUMBER: 331880898

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
87204(a)
Limitations -Capacity and Ambulatory Status
(a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including specification of the maximum number of persons who may receive services at any one time. An exception may be made in the case of catastrophic emergency when the licensing agency may make temporary exceptions to the approved capacity.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee has exceeded their approved capacity by accepting a sixth resident prior to the Department approving their capacity increase request, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/15/2026
Plan of Correction
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Licensee agreed to contact the fire department and obtain written approval of the capacity increase. Licensee will then provide a copy of the written approval to LPA. Plan of correction to be submitted to LPA by close of business on 04/15/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Carolyn Tuba
NAME OF LICENSING PROGRAM MANAGER:
Janette Romero
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2026


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 04/13/2026 04:35 PM - It Cannot Be Edited


Created By: Janette Romero On 04/13/2026 at 03:25 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: HELPING HANDS CARE HOMES
FACILITY NUMBER: 331880898

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87355(e)(3)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (3) Request a transfer of a criminal record clearance as specified in Section 87355(c) or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above by not associating V1 with the facility, which poses a potential health/safety risk to persons in care.
POC Due Date: 04/15/2026
Plan of Correction
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Licensee reported they will complete the Criminal Background Clearance Transfer Request (LIC 9182) for V1 requesting to associate them with the facility and email it to the Riverside Regional Office at CCLASCPRiversideRO@dss.ca.gov by close of business on 04/15/2026.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Carolyn Tuba
NAME OF LICENSING PROGRAM MANAGER:
Janette Romero
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2026


LIC809 (FAS) - (06/04)
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