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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700251
Report Date: 02/11/2025
Date Signed: 02/11/2025 04:43:59 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/11/2025 04:43 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:ABOVE & BEYOND IN HOME CARE, LLCFACILITY NUMBER:
374700251
ADMINISTRATOR/
DIRECTOR:		WALKER, KRISTENFACILITY TYPE:
300
ADDRESS:2100 PALOMAR AIRPORT RD #214TELEPHONE:
(442) 500-5089
CITY:CARLSBADSTATE: CAZIP CODE:
92011
CAPACITY: CENSUS: DATE:
02/11/2025
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Kristen WalkerTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On February 11.2025 Home Care Services Bureau (HCSB) Enforcement Analyst (EA) Adrian Mangina arrived at the business office of Above & Beyond in Home Care, LLC for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Designee Kristen Walker. Analyst Mangina observed the proper posting of business hours and license. Designee Walker provided Analyst an area in which the review of personnel and administrative files could be performed. Designee provided Analyst with current Certificate of Insurance showing that professional liability policy and dishonesty bond are current. Licensee unable to provide proof of worker's compensation policy at time of inspection. There are no Home Care Aides and no clients at this time. No employee files were reviewed.

Upon completion of the file review Analyst discussed the findings of the inspection with Designee. The Analyst informed the representative named above of the deficiency found and explained it would be noted on the HCS809-D form. In addition, Ms. Walker was provided a copy of the HCS9058 Appeal Rights form.
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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 02/11/2025 04:43 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 02/11/2025 at 04:29 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: ABOVE & BEYOND IN HOME CARE, LLC
FACILITY NUMBER: 374700251

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/25/2025
Section Cited
1796.42(b)
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LICENSINE POSTING, INSURANCE, AND ABUSE REPORTING: 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.

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This requirement was not met as evidenced by: during the review of files Licensee was not able to provide proof of worker's compensation insurance at time of inspection, a finding that 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: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
LIC809 (FAS) - (06/04)
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