342700073-1-23-2026-59-AS-MHOD-DQM2TZ-20260123164135

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342700073
Report Date: 01/23/2026
Date Signed: 01/23/2026 05:27:15 PM

Document Has Been Signed on 01/23/2026 05:27 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	PEOPLE'S CARE WINFIN		FACILITY NUMBER:	342700073
ADMINISTRATOR/ DIRECTOR:	SMITH, TAUSHA		FACILITY TYPE:	735
ADDRESS:	3418 WINFIN WAY		TELEPHONE:	(916) 480-9660
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY: 4		CENSUS: 3	DATE:	01/23/2026
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	04:15 PM
MET WITH:	Adedeji Mapaderun, Administrator		TIME VISIT/ INSPECTION COMPLETED:	04:55 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	Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Adedeji Mapaderun to follow-up regarding a case management visit conducted on October 7, 2022 in regards to four (4) incident reports received by the Department involving client funds being misappropriated by a prior administrator. The Department was unable to determine if the facility's prior administrator misappropriated the clients funds, but was able to determine that the funds were misappropriated by someone working for the licensee. Per Title 22, the Administrator shall have the knowledge of and ability to comply with applicable law and regulations, including the ability to maintain or supervise the maintenance of financial and other records. On July 8, 2022, Administrator (S1) sent multiple emails to the payee requesting P&I for three (3) clients totaling $4,100. P&I was for client (C1) for $600, client (C2) for $1,500, and client (C3) for $2,000. On July 11, 2022, payee issued P&I for $4,100 to People's Care Northern California for the three (3) clients. On July 17, 2022, S1 submitted a resignation letter to People's Care Northern California, with last day of employment to be July 30, 2022. On July 18, 2022, People's Care Northern California issued a check to S1 for $4,100 for the clients' P&I. Check was cashed by S1 on July 23, 2022. On July 25, 2022, staff (S2) talked on the telephone with S1. S1 asked if staff could access the safe to verify the security code on the back of the credit card. Staff was unaware the facility had a safe. Staff was able to get into the safe and S1 sounded confused as S1 was sure the last time they were at the facility, they closed and locked the safe. Staff noticed that the binders were put in straight and should have been put in diagonally, causing the safe to not properly close. Staff rearranged the binders and locked the safe. On July 29, 2022, S1's employment terminated as the administrator for the facility. Report continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 5

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)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PEOPLE'S CARE WINFIN	FACILITY NUMBER: 342700073
	VISIT DATE: 01/23/2026

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
26
27
28
29
30
31
32

On August 2, 2022, Administrator (S3) and District Manager (S4) conducted a P&I check at the facility. They opened the safe and determined that the P&I folder with the client's cash was missing. This included the $4,100 cash for the check dated July 18, 2022. S4 was notified by S1 of what occurred on July 25, 2022 in which the safe was found open.

Interview conducted with S1 indicated that they never had any issues with money missing or being low. S1 stated that client funds were obtained via check made out to the administrator, cashed by the administrator, and placed in a locked binder. S1 stated that staff member (S5) also has access to the safe, but they don't think S5 would have taken the money. S1 stated that they did not remember cashing a check on July 23, 2022 as they didn't return to the facility after July 17, 2022. The Department reviewed several documents with S1's signature along with signature on the back of the cashed check and was unable to determine that the signature on the check is S1's.

The Department reviewed P&I records for C1. During the period of July to September 2022 the ledger balance of $9.65 did not rollover. The total owed to C1 from the licensee is $9.65. The Department reviewed the P&I records for C2. The balance on March 3, 2022 was $89.89 and the next entry on April 1, 2022 show a balance of $2.71, without any withdrawals in between. C2 was shorted $87.18. During the period of July to September 2022 the ledger balance of $37.45 did not rollover. The combined total owed to C2 from the licensee is $124.93. The Department reviewed the P&I records for C3. During the period of July to September 2022 the ledger balance of $9.64 did not rollover. The total owed to C3 from the licensee is $9.64. The Department reviewed the P&I records for client (C4). During the review, the Department observed that a check was issued from payee for C4 on April 29, 2022 in the amount of $600. The $600 was not noted on the client ledgers for 2022. Per a conversation with S4 on January 26, 2023, the corporate office received the check from payee, but it was not cashed. The corporate office issued a check to the facility and the $600.00 was put in C4’s folder and added to the ledger on January 27, 2023. The cash handling procedures for client’s P&I is the same for all of the licensed facilities for People’s Care Northern California, LLC. Funds are requested from the payee and a check is issued to the corporate office. The corporate office issues a check to the facility administrator, they cash the check, and the P&I is secured at the facility.

** Report continued on 809-C **

NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PEOPLE'S CARE WINFIN	FACILITY NUMBER: 342700073
	VISIT DATE: 01/23/2026

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
26
27
28
29
30
31
32

Facility ledgers, receipts, and payee ledgers were reviewed for client deposits and withdrawals. Client facility ledgers were not accounted for correctly and funds were missing at the facility. The Department was unable to determine that the former administrator was the person that signed and cashed the check for $4,100 and stole the client’s P&I money. Although based on the interviews conducted and documentation received, someone associated to the licensee took the money. The licensee has reimbursed $4,100 to clients as follows: C1 ($600), C2 ($1,500), and C3 ($2,000). C4 had the $600 from April of 2022 added to the P&I at the facility and is noted on the ledger. C1, C2, and C3 all had money that did not get rolled over from the July ledgers to the September ledgers and should be refunded. The Department requests the licensee reimburse the clients as follows: C1 - $9.65, C2 - $124.93, and C3 - $9.64

As a result of today's inspection, deficiencies are being cited pursuant to California Code of Regulations, Title 22, Division 6, Chapter 8. Deficiencies are listed on 809-D page.

Exit interview was conducted. A copy of this report and appeal rights were provided. Signature on these forms acknowledges receipt of these documents.

NAME OF LICENSING PROGRAM MANAGER: Anthony Perez
NAME OF LICENSING PROGRAM ANALYST: Michael Hood
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 01/23/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 01/23/2026 05:27 PM - It Cannot Be Edited

Created By: Michael Hood On 01/23/2026 at 03:53 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: PEOPLE'S CARE WINFIN	FACILITY NUMBER: 342700073
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/23/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/13/2026 Section Cited CCR 80064(a)(4)	1 2 3 4 5 6 7	80064 Administrator - Qualifications and Duties (a) The administrator shall have the following qualifications: (4) Ability to maintain or supervise the maintenance of financial and other records. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will complete a statement of understanding regarding regulation 80064 and submit statement to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interviews conducted and records reviewed, Licensee did not ensure that the administrator had the ability to maintain and supervise the maintenance of financial records of the residents, which poses a potential health, safety, and personal rights violation to the residents in care.	8 9 10 11 12 13 14
Type B 02/13/2026 Section Cited CCR80026(h)(1)	1 2 3 4 5 6 7	80026 Safeguards for Cash Resources, Personal Property, and Valuables states: (h) Each licensee shall maintain accurate records of accounts of cash resources, personal property, and valuables entrusted to his/her care, including, but not limited to the following: (1) Records of clients' cash resources maintained as a drawing account, which shall include a current ledger accounting, with columns for income, disbursements and balance, for each client. Supporting receipts for purchases shall be filed in chronological order. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will refund the necessary clients with the amounts listed on the 809 report. Licensee will provide proof of refund to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interviews conducted and records reviewed, Licensee did not ensure that an accurate account of the clients' cash resources was maintained, which poses a potential health, safety, and personal rights violation to the residents in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Anthony Perez
NAME OF LICENSING PROGRAM MANAGER:

	Michael Hood
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/23/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026

LIC809 (FAS) - (06/04)

Page: 5 of 5