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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700374
Report Date: 04/25/2025
Date Signed: 04/25/2025 04:09:04 PM

Document Has Been Signed on 04/25/2025 04:09 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:HUB SENIOR HOME CARE LLC, THEFACILITY NUMBER:
374700374
ADMINISTRATOR/
DIRECTOR:		OLIVIA NANQUILFACILITY TYPE:
300
ADDRESS:9880 CARROLL CANYON RD APT301TELEPHONE:
(619) 679-5204
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY: CENSUS: DATE:
04/25/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:29 PM
MET WITH:Olivia NanquilTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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On April 25, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst, Adrian Mangina arrived at the new business office of Hub Senior Home Care LLC at 1132 Via Rancho Parkway Escondido, CA 92029due to change of location submitted but not yet processed. Licensee Olivia Nanquil provided EA Mangina entry into the residential office. Analyst Mangina observed the proper posting of business hours.The Analyst was provided an area in which the review of personnel and administrative files could be performed. Analyst was provided with proof of current professional liability policy, worker's compensation, and dishonesty bond. Four employee files were reviewed.

Upon completion of the file review the analyst discussed the findings of the inspection with Ms. Nanquil. The Analyst informed the representative named above of the deficiency found and explained it would be noted on the HCS809-D form. In addition, the Licensee was provided a copy of the HCS9058 Appeal Rights form

NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2025
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 04/25/2025 04:09 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 04/25/2025 at 02:10 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: HUB SENIOR HOME CARE LLC, THE
FACILITY NUMBER: 374700374

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/26/2025
Section Cited
1796.44(b)(2)
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Training Requirements:.(b) An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows.. (2) 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: During the review of files on 4/25/25 Licensee was not able to provide at time of inspection proof that Reference #1, #3, and #4, completed 3 of 3 hours entry-level training including basic safety precautions, emergency procedures, and infection control, 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: 04/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2025
LIC809 (FAS) - (06/04)
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