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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700372
Report Date: 08/08/2025
Date Signed: 08/08/2025 03:15:32 PM

Document Has Been Signed on 08/08/2025 03:15 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 1ST HOME CARE LLCFACILITY NUMBER:
374700372
ADMINISTRATOR/
DIRECTOR:		RIVAS, EMANUELFACILITY TYPE:
300
ADDRESS:1227 BOSTONIA STTELEPHONE:
(858) 238-7128
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: CENSUS: DATE:
08/08/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:unavailableTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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On August 8, 2025, at 2:30 PM, Enforcement Analyst (EA) Adrian Mangina made a third attempt to conduct an unannounced Biennial inspection of Care1st Home Care LLC. Enforcement Analyst (EA) Adrian Mangina arrived during posted business hours and Licensee was not at the licensed office and did not answer a call placed by EA or respond to the voicemail left on the business phone number. EA attempted to call the alternate phone number but no one answered and the message bank was full. EA waited at the Home Care Organization until 3:00 PM but owner did not arrive and did not return the call.

Owner was advised during a courtesy call on 3/28/25 that a designee should be present during posted business hours. Owner has not been present as required for each inspection attempt and has not made changes to posted business hours, this continued non-compliance constitutes refusal to provide records. Per Statute, A Licensee or Designee shall be continuously present during the Home Care Organization’s (HCO) posted business office hours. Any additional incomplete inspections may result in additional penalties. Please notify your Licensing Analyst and Enforcement of any changes to the HCO location or anticipated hours of operation.

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: 08/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2025
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 08/08/2025 03:15 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 08/08/2025 at 03:00 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
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: CARE 1ST HOME CARE LLC
FACILITY NUMBER: 374700372

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/13/2025
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 was not present during regular business hours on mutiple occasions and thus has effectively refused to provide records to the Daprtment as required, including insurance policies and employee files 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: 08/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2025
LIC809 (FAS) - (06/04)
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