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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700274
Report Date: 03/12/2025
Date Signed: 03/12/2025 04:00:56 PM

Document Has Been Signed on 03/12/2025 04:00 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:RELIABLE HOME CARE OF SAN DIEGO, LLCFACILITY NUMBER:
374700274
ADMINISTRATOR/
DIRECTOR:		CLAUDIO, LUIS DE JESUSFACILITY TYPE:
300
ADDRESS:713 ESLA DRTELEPHONE:
(619) 638-1921
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: CENSUS: DATE:
03/12/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Luis De Jesus ClaudioTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On March 12, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the business office of Reliable Home Care of San Diego LLC for a Biennial inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by Licensee Luis De Jesus Claudio.. Analyst Mangina observed the proper posting of business hours and license. The Analyst was provided an area in which the review of personnel and administrative files could be performed. Licensee provided Analyst with proof of current professional liability policy, worker's compensation, and dishonesty bond. Ten employee files were reviewed.

Upon completion of the file review the analyst discussed the findings of the inspection with License De Jesus Claudio. 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 the HCS9058 Appeal Rights form.

LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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 03/12/2025 04:00 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 03/12/2025 at 03:27 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: RELIABLE HOME CARE OF SAN DIEGO, LLC
FACILITY NUMBER: 374700274

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/13/2025
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 of files on 3/12/25 Licensee was not able to provide at time of inspection proof of Home Care Registry clearance for Reference #1, #2, and #3, 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: 03/12/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
LIC809 (FAS) - (06/04)
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