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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 434700185
Report Date: 03/27/2025
Date Signed: 04/02/2025 08:13:02 AM

Document Has Been Signed on 04/02/2025 08:13 AM - 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:AFFORDABLE SENIOR CAREFACILITY NUMBER:
434700185
ADMINISTRATOR/
DIRECTOR:		PATRICIA CUADROSFACILITY TYPE:
300
ADDRESS:286 E. HAMILTON AVE. #DTELEPHONE:
(408) 559-2810
CITY:CAMPBELLSTATE: CAZIP CODE:
95008
CAPACITY: CENSUS: DATE:
03/27/2025
POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Patricia CuadrosTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Enforcement Analyst (EA), Ramsey Chimienti, with the Home Care Services Branch (HCSB) conducted an on-site visit for the purpose of a Plan of Correction (POC) inspection on 3/27/25. EA Chimienti arrived at the business office of Affordable Senior Care and was informed by a representative from a neighboring business that the Designee was not present at the office.

EA then contact Designee, Patricia Cuadros, via phone and explained that the inspection was prompted due to the Home Care Organization’s (HCO) failure to submit corrections for deficiencies cited during a previous licensing inspection on 6/7/24. The previous plan of correction included instructions to scan and email several items to the HCO’s assigned licensing analyst. Requested items included proof of clearance, TB test results, and training logs for all caregivers. As of 3/27/25, these required corrections were not provided to the Department.

In order to complete the POC inspection, EA Chimienti instructed the HCO to provide the three most recent months of payroll, a list of all caregivers, a list of current clients and access to the HCO’s Axis Care account which houses all personnel documents required by HCSB.

The Designee indicated that additional time would be needed to obtain the requested documents and to grant database access for the analyst. Designee Cuadros acknowledged the requirements and agreed to submit the requested items by end of business day on Saturday 3/29/25. The Designee also agreed to send the previously requested documents to both EA and licensing analyst.

Analyst Chimienti concluded the telephone visit with the Designee and emailed a copy of the HCS 809 report.

NAME OF LICENSING PROGRAM ANALYST: Ramsey Chimienti
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/27/2025
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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