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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700041
Report Date: 03/19/2026
Date Signed: 03/19/2026 12:43:41 PM

Document Has Been Signed on 03/19/2026 12:43 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:WAY COOL HOMECARE, INC.FACILITY NUMBER:
374700041
ADMINISTRATOR/
DIRECTOR:		MOURA EVERHARTFACILITY TYPE:
300
ADDRESS:9745 PROSPECT AVE, STE 203TELEPHONE:
(619) 444-3200
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: CENSUS: DATE:
03/19/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Benjamin EverhartTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
NARRATIVE
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On March 19, 2026, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina conducted a virtual biennial Inspection via Teams of Way Cool Homecare Inc.. Upon commencement of the inspection the Enforcement Analyst identified herself and displayed employee badge. Analyst was greeted by Designee Benjamin Everhart who presented their California Driver’s License. Analyst was provided employee files for review prior to this inspection. During the virtual inspection, Designee walked the premises and allowed Analyst Mangina to observe the proper posting of License and business hours. Analyst also viewed proof of valid professional liability policy, worker's compensation, and dishonesty bond before the inspection.

Upon completion of the file review the analyst discussed the findings of the inspection with Designee. The Analyst informed the representative named above of the deficiencies found and explained they would be noted on the HCS809-D form. In addition, the Licensee was provided a copy of this report and the HCS9058 Appeal Rights form via email and will return a signed copy of the report to Analyst upon receipt.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
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Document Has Been Signed on 03/19/2026 12:43 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 03/19/2026 at 10:48 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: WAY COOL HOMECARE, INC.
FACILITY NUMBER: 374700041

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/19/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/23/2026
Section Cited
1796.44(b)(2)
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TRAINING REQUIREMENTS:An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows: 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: A review of training records provided found that Licensee was not able to provide proof that reference #1, #2, #3, #4, 5 and #6 completed of required 1 of 3 hours entry-level training including: emergency procedures prior to client contact, 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: 03/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2026
LIC809 (FAS) - (06/04)
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