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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700378
Report Date: 06/24/2026
Date Signed: 06/25/2026 12:19:49 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 06/25/2026 12:19 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:EUCALYPTUS HOME CARE LLCFACILITY NUMBER:
374700378
ADMINISTRATOR/
DIRECTOR:		JAMES DICKSONFACILITY TYPE:
300
ADDRESS:16950 VIA DE SANTA FE, STE 132TELEPHONE:
(858) 900-3050
CITY:RANCHO SANTA FESTATE: CAZIP CODE:
92067
CAPACITY: CENSUS: DATE:
06/24/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Delair Alnajjar and James DicksonTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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Enforcement Analyst (EA), Adrian Mangina, with the Home Care Services Branch (HCSB) conducted an announced visit for the purpose of a biennial inspection. The EA met with the licensees, Delair Alnajjar and James Dickson. During tour of the facility, EA observed the posting of the license and business hours. Business operating hours are 10:00 am - 2:00 pm Monday, Wednesday, and Friday.

During the inspection, the EA reviewed personnel records for licensees, 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 violation being cited in accordance with Health and Safety Code, Section 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 (HCS 859) were provided to the licensees Delair Alnajjar and James Dickson via email.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2026
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 06/25/2026 12:19 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 06/24/2026 at 01:39 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: EUCALYPTUS HOME CARE LLC
FACILITY NUMBER: 374700378

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2026
Section Cited
1796.44(c)
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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 #4 has complete 5 of 5 hours required annual training, including, 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, 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: 06/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2026
LIC809 (FAS) - (06/04)
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