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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 374700394
Report Date: 05/06/2025
Date Signed: 05/06/2025 01:22:25 PM

Document Has Been Signed on 05/06/2025 01:22 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:SUPERIOR HOME CARE SERVICES, INC.FACILITY NUMBER:
374700394
ADMINISTRATOR/
DIRECTOR:		MORKOS, MAIKELFACILITY TYPE:
300
ADDRESS:2182 S EL CAMINO REAL STE 205TELEPHONE:
(714) 855-8728
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY: CENSUS: DATE:
05/06/2025
Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Kjella OgrinTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On May 6, 2025, Home Care Services Bureau (HCSB) Enforcement Analyst (EA), Adrian Mangina arrived at the business office of Superior Home Care Services Inc. for a Post Licensing inspection. Upon arrival EA was admitted to the office by Eleanor Chavez and Penelope Mercado. Ms. Chavez called owner Maikel Morkos who provided Home Care Organization Designee name Kjella Ogrin and her phone number and stated Designee would come to meet EA shortly. Ms. Ogrin arrived at approximately 10:15 AM. Carol Lindsey, former owner and Regional Director arrived at 10:30 AM. 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. Designee will email Analyst proof of current professional liability policy, worker's compensation, and dishonesty bond. Twelve employee files were reviewed.

Upon completion of the file review the analyst discussed the findings of the inspection with Ms. Ogrin and Ms.Lindsey. The Analyst informed the representatives named above of the deficiencies found and explained they would be noted on the HCS809-D forms. 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: 05/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

HCS809 (FAS) - (06/04)
Page: 1 of 4
Document Has Been Signed on 05/06/2025 01:22 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 05/06/2025 at 11:51 AM
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: SUPERIOR HOME CARE SERVICES, INC.
FACILITY NUMBER: 374700394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/07/2025
Section Cited
1796.23(a)
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Fingerprint requirements: (a) Each person initiating a background examination to be a registered home care aide shall submit their fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision (d).
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This requirement was not met as evidenced by: During the review of files on 5/6//25 Licensee was not able to provide proof of fingerprint clearance at time of inspection for Reference #1, 2,3,4,5,6,7,8,10 and 11 at time of inspection, a finding which poses an immediate health and safety risk to persons in care.
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Type A
05/07/2025
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 5/6/25 Licensee was not able to provide at time of inspection proof of Home Care Registry clearance for Reference #1,2,3,4,5,6,7,8,9,10, and11, at time of inspection, 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: 05/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/06/2025 01:22 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 05/06/2025 at 12:10 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: SUPERIOR HOME CARE SERVICES, INC.
FACILITY NUMBER: 374700394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/07/2025
Section Cited
1796.44(b)(1)
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TRAINING REQUIRMENTS :An affiliated home care aide shall complete a minimum of five hours of entry-level training prior to presence with a client, as follows: Two hours of orientation training regarding his or her role as caregiver and the applicable terms of employment.
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 This requirement was not met as evidenced by: During the review of files on 5/1/25 Licensee was not able to provide proof at time of inspection that Reference Reference #1,2,3,4, 5, 6, 7 ,8, 9,10,11,and 12 completed entry-level 2-hour entry-level orientation training , a finding which poses an immediate health and safety risk to persons in care.
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Type A
05/07/2025
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: 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 5/6/25 Licensee was not able to provide at time of inspection proof that Reference #1, 2,3,4,5,6,7,8,9,10.11. and 12, completed 3 of 3 hours entry-level training including basic safety precautions, emergency procedures, 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: 05/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/06/2025 01:22 PM - It Cannot Be Edited


Created By: Adrian L Mangina On 05/06/2025 at 12:20 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: SUPERIOR HOME CARE SERVICES, INC.
FACILITY NUMBER: 374700394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/07/2025
Section Cited
1796.45(a)
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TB TESTING: Affiliated home care aides hired on or after January 1, 2016, shall submit to an examination 90 days prior to employment, or within seven days after employment, to determine that the individual is free of active tuberculosis disease
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This requirement was not met as evidenced by: During the review of files on 5/6/25 Licensee could not provide proof of negative TB test at time of inspection for Reference #1,2,3,4, 5, 6, 7 ,8,10,11, a finding which poses an immediate health and safety risk to persons in care.
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Type A
05/07/2025
Section Cited
1796.45(c)
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TB testing: After submitting to an examination, an affiliated home care aide whose test for tuberculosis infection is negative shall be required to undergo an examination at least once every two years.
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This requirement was not met as evidenced by: During the review of files on 5/6/25, Licensee could not provide proof of negative TB test f at time of inspection or reference #12 was obtained at least every 2 years as required, 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: 05/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2025
LIC809 (FAS) - (06/04)
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