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

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700169
Report Date: 04/17/2026
Date Signed: 04/17/2026 01:24:00 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 04/17/2026 01:24 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:AMERICAN HOME CARE 1 INCFACILITY NUMBER:
334700169
ADMINISTRATOR/
DIRECTOR:		AIELLO, SHAUNA M.FACILITY TYPE:
300
ADDRESS:4740 GREEN RIVER RD #113TELEPHONE:
(951) 734-8993
CITY:CORONASTATE: CAZIP CODE:
92878
CAPACITY: CENSUS: DATE:
04/17/2026
Required - 2 YearANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Danelle Boncheff, DesigneeTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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 Analyst (EA), Jane Cong-Huyen, with the Home Care Services Branch (HCSB) conducted a virtual visit for the purpose of a biennial inspection. EA met with the HCO representative, Danelle Boncheff. Per virtual tour of the facility, EA observed the posting of the license and operating business hours. Business operating hours are from 8:00am - 4:00pm, Monday through Friday.

During the inspection, EA reviewed personnel records for Home Care Aides (HCAs) including fingerprint status, HCA registry status, Tuberculosis (TB), and required training(s). EA also reviewed the HCO’s business records for insurance requirements.

Based on the file review, EA informed the licensee of the deficiency found and noted on the 809D. An exit interview was conducted, a copy of the reports (HCS809 & HCS809D), staff records review (HCS 859), and appeal rights were provided to HCO representative, Danelle Boncheff, via email.

NAME OF LICENSING PROGRAM ANALYST: Jane Cong-Huyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2026
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 04/17/2026 01:24 PM - It Cannot Be Edited


Created By: Jane Cong-Huyen On 04/17/2026 at 10:28 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: AMERICAN HOME CARE 1 INC
FACILITY NUMBER: 334700169

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2026
Section Cited
1796.14 (b)
1
2
3
4
5
6
7
1796.14(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 evidence by: based on file review. HCA #5 did not a valid home care registry. This poses an immedicate health & safety code to clients in care.
1
2
3
4
5
6
7
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: Jane Cong-Huyen
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2026
LIC809 (FAS) - (06/04)
Page: 2 of 2