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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700088
Report Date: 06/20/2024
Date Signed: 06/20/2024 01:11:36 PM

Document Has Been Signed on 06/20/2024 01:11 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:CARE FOR ALL SAN DIEGOFACILITY NUMBER:
374700088
ADMINISTRATOR/
DIRECTOR:		HEIDI KLASTOWFACILITY TYPE:
300
ADDRESS:1851 GRANITE HILLS DRTELEPHONE:
(520) 275-7739
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY: CENSUS: DATE:
06/20/2024
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Misty CarterTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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Home Care Services Bureau (HCSB) Analyst Adrian Mangina arrived at the business office of Care for All San Diego on 6/20/2024 for a Biennial inspection. Upon arrival, the HCSB analyst identified herself and was greeted by Designee Misty Carter. Designee was in process of moving office and license and hours were not posted. Analyst advised that license and hours must be posted at all times. Licensee Heidi Klastow was contacted by phone who stated that she is in process of renewal and has all staff files and insurance documents as well as original license with her. She is currently out of the country and will return next week. The analyst was unable to review personnel and administrative files. The analyst discussed the findings of the inspection with the Designee Misty Carter. The analyst informed the representative named above of the deficiencies found and explained they would be noted on the HCS809-D forms. In addition, the designee was provided a copy of the HCS9058 Appeal Rights form.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2024
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 06/20/2024 01:11 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 06/20/2024 at 12:45 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: CARE FOR ALL SAN DIEGO
FACILITY NUMBER: 374700088

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2024
Section Cited
1796.52(b)
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1796.52(b) The department shall verify through random, unannounced inspections that a home care organization meets the requirements of this chapter and the rules and regulations promulgated pursuant to this chapter.
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This requirement was not met as evidenced by: Staff files were not available for review a finding which poses a potential health and safety risks to persons in care.
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Type B
07/05/2024
Section Cited
1796.42
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1796.42 A home care organization licensee shall do all of the following:
(b) Maintain and abide by a valid workers’ compensation policy covering its affiliated home care aides.
(c) Maintain and abide by an employee dishonesty bond, including third-party coverage, with a minimum limit of ten thousand dollars ($10,000).
(d) Maintain proof of general and professional liability insurance in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the aggregate.
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This requirement was not met as evidenced by: Designee could not provide insurance policies or dishonesty bond for review a finding which poses a potential health and safety risks 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: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2024
LIC809 (FAS) - (06/04)
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