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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 334700184
Report Date: 11/13/2024
Date Signed: 12/13/2024 07:45:53 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/13/2024 07:45 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:1HEART CAREGIVER SERVICESFACILITY NUMBER:
334700184
ADMINISTRATOR/
DIRECTOR:		CHOPITEA, ROVIE ANNEFACILITY TYPE:
300
ADDRESS:41593 WINCHESTER ROADTELEPHONE:
(951) 491-4050
CITY:TEMECULASTATE: CAZIP CODE:
92590
CAPACITY: CENSUS: DATE:
11/13/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Brian and Rovie Ann ChopiteaTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On November 13, 2024 Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the business office of !Heart Caregiver Services at 12:30 PM. Licensees were not present and Analyst called Licensees who stated that they were on their way. Licensees arrived at 1:00 PM to allow Analyst entry into the shared office space for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Licensees Brian and Rovie Ann Chopitea. Analyst Mangina observed the proper posting of business hours and license. The analyst was provided an area in which the review of personnel and administrative files could be performed. Licensees provided Analyst with current Certificate of Insurance showing that professional liability policy, worker's compensation, and dishonesty bond are current. Employee files were reviewed.

Upon completion of the file review the analyst discussed the findings of the inspection with Licensees. The analyst informed the representatives named above of the deficiencies found and explained they would be noted on the HCS809-D forms. In addition, the Licensee were provided a copy of the HCS9058 Appeal Rights form.

LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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 3
Document Has Been Signed on 12/13/2024 07:45 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 11/13/2024 at 02:20 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: 1HEART CAREGIVER SERVICES
FACILITY NUMBER: 334700184

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/14/2024
Section Cited
1796.44(b)(2)
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b) An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows:(1) Two hours of orientation training regarding his or her role as caregiver and the applicable terms of employment.
(2) Three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
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This requirement was not met as evidenced by: During review of files it was discovered that 10 of 10 Home Care Aides did not complete entry level training as required, a finding which poses an immediate health and safety risk to persons in care.
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Type A
11/14/2024
Section Cited
1796.45(c)
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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.
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This requirement was not met as evidenced by: During review of files it was discovered that Reference #6 had a TB test that expired 10/11/24 and did not provide a new negative TB test as required, a finding which poses an immediate health and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 12/13/2024 07:45 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 11/13/2024 at 03:19 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: 1HEART CAREGIVER SERVICES
FACILITY NUMBER: 334700184

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2024
Section Cited
1796.44 (c)
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Training Requirements: (c) In addition to the requirements in subdivision (b), an affiliated home care aide shall complete a minimum of five hours of annual training. The annual training shall relate to core competencies and be population specific, which shall include, but not be limited to, the following areas:
(1) Clients’ rights and safety.
(2) How to provide for, and respond to, a client’s daily living needs.
(3) How to report, prevent, and detect abuse and neglect.
(4) How to assist a client with personal hygiene and other home care services.
(5) If transportation services are provided, how to safely transport a client.
(d) The entry-level training and annual training described in subdivisions (b) and (c) may be completed through an online training program.
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This requirement was not met as evidenced by: During review of files it was discovered that Reference #6 did not complete annual training for 2024 as required, a finding which poses a potential and safety risk to persons 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: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
LIC809 (FAS) - (06/04)
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