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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 484700022
Report Date: 01/07/2022
Date Signed: 01/07/2022 12:07:15 PM

Document Has Been Signed on 01/07/2022 12:07 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
CCLD Regional Office, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME:ABUNDANCE IN LOVE HOME CARE AGENCYFACILITY NUMBER:
484700022
ADMINISTRATOR:MELINDA WARDFACILITY TYPE:
300
ADDRESS:852 COVENTRY LANETELEPHONE:
(707) 400-7886
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 0CENSUS: DATE:
01/07/2022
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
11:52 AM
MET WITH:Melinda WardTIME COMPLETED:
01:00 PM
NARRATIVE
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Home Care Services Bureau (HCSB) analyst, Ramsey Chimienti arrived at the business office of Abundance in Love Home Care Agency on 1/7/2022. Upon arrival, the HCSB analyst identified himself and was greeted by Melinda Ward. The proper posting of business hours and license was observed. The analyst was then shown to an area where the review of personnel and administrative files could be performed. Upon completion of the file review the analyst discussed the findings of the inspection with the DESIGNEE_LICENSEE. The analyst informed HIM_HER of the deficiencies found and explained they would be noted on the HCS 809D.
LICENSING EVALUATOR NAME: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2022
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 2
Document Has Been Signed on 01/07/2022 12:07 PM - It Cannot Be Edited


Created By: Ramsey Chimienti On 01/07/2022 at 11:54 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

FACILITY NAME: ABUNDANCE IN LOVE HOME CARE AGENCY

FACILITY NUMBER: 484700022

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 01/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2022
Section Cited
1796.44
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1796.44
(a) A home care organization licensee shall ensure that prior to providing home care services, an affiliated home care aide shall complete the training requirements specified in this section.
(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:
(1) Two hours of orientation training regarding his or her role as caregiver and the applicable terms of employment.
(2) Three hours of safety training, including basic safety precautions, emergency procedures, and infection control.
(c) 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:
(1) Clients’ rights and safety.
(2) How to provide for and respond to a client’s daily living needs.
(3) How to report, prevent, and detect abuse and neglect.
(4) How to assist a client with personal hygiene and other home care services.
(5) If transportation services are provided, how to safely transport a client.
(d) The entry-level training and annual training on department-approved job-related topics described in subdivisions (b) and (c) may be completed through an online training program.
Type B
02/18/2022
Section Cited
1796.45
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1796.45
(a) An individual hired to be an affiliated home care aide on or after January 1, 2015, shall be submitted 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.
(b) For purposes of this section, “examination” means a test for tuberculosis infection that is recommended by the federal Centers for Disease Control and Prevention (CDC) and that is licensed by the federal Food and Drug Administration (FDA) and, if that test is positive, an X-ray of the lungs. The aide shall not work as an affiliated home care aide unless he or she obtains documentation from a licensed medical professional that there is no risk of spreading the disease.
(c) An affiliated home care aide whose employment with a home care organization began before January 1, 2015, shall submit to the examination described in subdivision (a) before July 1, 2015.
(d) 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. Once an affiliated home care aide has a documented positive test for tuberculosis infection that has been followed by an X-ray, the examination is no longer required.
(e) After the examination, an affiliated home care aide shall submit, and the home care organization shall keep on file, a certificate from the examining practitioner showing that the affiliated home care aide was examined and found free from active tuberculosis disease.
(f) The examination is a condition of initial and continuing employment with the home care organization. The affiliated home care aide shall pay the cost of the examination.
(g) An affiliated home care aide who transfers employment from one home care organization to another shall be deemed to meet the requirements of subdivision (a) or (c) if the affiliated home care aide can produce a certificate showing that he or she submitted to the examination within the past two years and was found to be free of active tuberculosis disease, or if it is verified by the home care organization previously employing him or her that it has a certificate on file that contains that showing.
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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: Ramsey Chimienti
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2022
LIC809 (FAS) - (06/04)
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