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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700258
Report Date: 07/08/2026
Date Signed: 07/08/2026 11:56:23 AM

Document Has Been Signed on 07/08/2026 11:56 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:LEGACY CARE LLCFACILITY NUMBER:
374700258
ADMINISTRATOR/
DIRECTOR:		CHAPELE, AMREFACILITY TYPE:
300
ADDRESS:2150 N CENTRE CITY PKWY STE KTELEPHONE:
(619) 734-7493
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: CENSUS: DATE:
07/08/2026
Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Ese ChapeleTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
NARRATIVE
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Enforcement Analyst (EA), Adrian Mangina, with the Home Care Services Branch (HCSB) conducted an announced on site visit for the purpose of a biennial inspection. The EA met with the licensee, Ese Chapele. Operation Assistant Bizhan Romani was also present. During tour of the facility, EA observed the posting of the license and business hours. Business operating hours are 10:00 AM to 2:00 pm Monday through Friday.
During the inspection, the EA reviewed personnel records for licensee, and Home Care Aides including fingerprint status, registry status, Tuberculosis (TB), and required training. The Home Care Organization’s (HCO’s) business records were also reviewed during the visit including the insurance requirements.

During file review EA observed the following violations being cited in accordance with Health and Safety Code 1796.43(a), 1796.23(a) , 1796.44(b)(2), 1796.44(c) on attached HCS809D.

An exit interview was conducted, a copy of this report, Home Care Organization Evaluation Report (HCS809), Appeal Rights (HCS9058), and Review of Staff Records (HCS859) were provided to the licensee, Ese Chapele, via email.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 4
Document Has Been Signed on 07/08/2026 11:56 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 07/08/2026 at 11:10 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: LEGACY CARE LLC
FACILITY NUMBER: 374700258

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/09/2026
Section Cited
1796.43(a)
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EMPLOYEES, VOLUNTEERS, AND AFFILIATED HOME CARE AIDE REQUIREMENTS: Home care organizations that employ affiliated home care aides shall ensure the affiliated home care aides are cleared on the home care aide registry before placing the individual in direct contact with clients.
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This requirement was not met as evidenced by: During the review information provided, Licensee did not provide proof that Reference #1, #2, and #5, are affiliated with the Home Care Organization, a finding which poses an immediate health and safety risk to persons in care.
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Type A
07/09/2026
Section Cited
1796.23(a)
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Licensee will immediately remove Reference #1, #2, #3, #5, and #6 from client contact until fingerprint cleared and will scan proof of fingerprint clearance to adrian.mangina@dss.ca.gov no later than 7/9/26. In addition, Licensee acknowledges that they will ensure that in the future all employees of the Home Care Organization have fingerprint clearances. before they are allowed any client contact.
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This requirement was not met as evidenced by: during a review of records provided, Licensee did not provide proof of fingerprint clearance for reference #1, #2, and #5 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: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2026
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 07/08/2026 11:56 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 07/08/2026 at 11:17 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: LEGACY CARE LLC
FACILITY NUMBER: 374700258

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/09/2026
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 records provided, Licensee did not provide proof that reference #1, #3, #4, #5, and #6 completed 3 of 3 hours basic safety training including infection control, basic safety, and emergency procedures, as each completed only 2/5 hours entry level training, 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: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 07/08/2026 11:56 AM - It Cannot Be Edited


Created By: Adrian L Mangina On 07/08/2026 at 11:25 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: LEGACY CARE LLC
FACILITY NUMBER: 374700258

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/08/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2026
Section Cited
1796.44(c)
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796.44(c) TRAINING REQUIREMENTS: In addition to the requirements in subdivision (b), an affiliated home care aide shall complete a minimum of five hours of annual training. The annual training shall relate to core competencies and be population specific, which shall include, but not be limited to, the following areas: Clients’ rights and safety, How to provide for, and respond to, a client’s daily living needs, How to report, prevent, and detect abuse and neglect., How to assist a client with personal hygiene and other home care services, If transportation services are provided, how to safely transport a client.
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This requirement was not met as evidenced by: During the review of files Licensee was not able to provide proof that References #3 and #5 have complete 5 of 5 hours required annual training, including, How to provide for, and respond to, a client’s daily living needs, How to assist a client with personal hygiene and other home care services, If transportation services are provided, how to safely transport a client, a finding which poses a potential 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: 07/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2026
LIC809 (FAS) - (06/04)
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