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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700386
Report Date: 06/03/2025
Date Signed: 06/03/2025 04:43:00 PM

Document Has Been Signed on 06/03/2025 04:43 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:SOCAL ELITE CARE PROVIDERS LLCFACILITY NUMBER:
374700386
ADMINISTRATOR/
DIRECTOR:		TABLAN-TENGSON, MARITESFACILITY TYPE:
300
ADDRESS:2189 JOHNSTON RDTELEPHONE:
(760) 807-1457
CITY:ESCONDIDOSTATE: CAZIP CODE:
92029
CAPACITY: CENSUS: DATE:
06/03/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Marites Tablan-TengsonTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On June 3, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Socal Elite Care Providers, LLC for a post licensing inspection. Upon arrival, the Enforcement Analyst identified herself and was greeted by owner Marites Tablan-Tengson. Analyst Mangina observed the proper posting of business hours and license. Analyst was provided with an area in which the review of personnel and administrative files could be performed. Owner provided Analyst with proof of valid professional liability policy, worker's compensation, and dishonesty bond. There are no clients and no employees at this time. No employee files were reviewed.

Licensee was reminded that per Statute all employees must have fingerprint clearances and TB tests (initial and every 2 years) and all Home Care Aides must additionally have completed initial training consisting of two (2) hours Orientation and three (3) hours safety training including basic safety precautions, emergency procedures, and infection control prior to working with clients, and annually complete five (5) hours additional training, as well as be registered and renewed biennially on the Home Care Aide Registry.

Upon completion of the file review Analyst discussed the findings of the inspection with Ms. Tablan-Tengson and informed Owner that no discrepancies were found.
NAME OF LICENSING PROGRAM ANALYST: Adrian L Mangina
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2025
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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