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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700121
Report Date: 05/12/2025
Date Signed: 05/12/2025 09:57:34 AM

Document Has Been Signed on 05/12/2025 09:57 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:INHERITANCE HOME CARE LLCFACILITY NUMBER:
374700121
ADMINISTRATOR/
DIRECTOR:		PRISCILLA ANDERSONFACILITY TYPE:
300
ADDRESS:2566 CATAMARAN WAY, STE 5TELEPHONE:
(619) 207-5760
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY: CENSUS: DATE:
05/12/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:unavailableTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
NARRATIVE
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On 5/12/25 at 9:00 AM Enforcement Analyst (EA) Adrian Mangina, an attempt was made to perform an unannounced inspection of Inheritance Home Care LLC. Enforcement Analyst (EA) Adrian Mangina has made two unsuccessful attempts to conduct inspection and review of Home Care Organization records. EA contacted Licensee and Designee via telephone and left voicemail to request review of files as no staff were present. A licensee or designee shall be continuously present during the Home Care Organization’s (HCO) posted business office hours. If limited office hours a Licensee or Designee should be available to produce requested records and documents within a reasonable amount of time. Any additional incomplete inspections may result in the issuance of civil penalties or possible license revocation.

Deficiency cited and was cited on the attached HCS809-D form and emailed to Licensee along with a copy of the HCS9058 Appeal Rights form.

NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2025
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 05/12/2025 09:57 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 05/12/2025 at 09:33 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: INHERITANCE HOME CARE LLC
FACILITY NUMBER: 374700121

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/15/2025
Section Cited
1796.52(c)
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An investigation or inspection conducted by the department pursuant to this chapter may include, but is not limited to, inspection of the books, records, or premises of a home care organization. A home care organization’s refusal to make records, books, or premises available shall constitute cause for the revocation of the home care organization’s license.
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This requirement was not met as evidenced by: Licensee continues to operate, but has provided limited office hours for review of files, and has not been present nor made themselves available for record review on two occasions 2/21/25 and 5/12/25, and further, did not respond to telephone request to provide a time to produce documents, thus was unable to provide employee files as required, which poses a potential 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: 05/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2025
LIC809 (FAS) - (06/04)
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