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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 564700046
Report Date: 08/08/2023
Date Signed: 08/08/2023 12:06:57 PM

Document Has Been Signed on 08/08/2023 12:06 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:AT HOME CARE RESOURCES INC.FACILITY NUMBER:
564700046
ADMINISTRATOR:ONYX JEM ONASINFACILITY TYPE:
300
ADDRESS:706 N VENTURA RDTELEPHONE:
(805) 919-9260
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: CENSUS: DATE:
08/08/2023
Case Management - Biennial Required ContinuationUNANNOUNCEDTIME BEGAN:
10:44 AM
MET WITH:ONYX JEM ONASINTIME COMPLETED:
11:48 AM
NARRATIVE
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Home Care Services Bureau (HCSB) Associate Government Program Analyst (AGPA) Megan Vigil, arrived at the business office of At Home Care Resources Inc. on 8/8/2023 at approximately 10:30am. Upon arrival, AGPA Vigil identified herself and was greeted by Licensee, Onyx Onasin. 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. The proof of insurance's record was reviewed. Upon completion of the file review the analyst discussed the findings of the inspection with the Licensee, Onyx Onasin. The analyst informed the Licensee, Onyx Onasin of the deficiencies found and explained they would be noted on the 809D.
LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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 08/08/2023 12:06 PM - It Cannot Be Edited


Created By: Megan Vigil On 08/08/2023 at 11:49 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: AT HOME CARE RESOURCES INC.
FACILITY NUMBER: 564700046

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/18/2023
Section Cited
1796.23 (a)
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Each person initiating a background examination to be a registered home care aide shall submit his or her fingerprints to the Department of Justice by electronic transmission in a manner approved by the department, unless exempt under subdivision
Type A
08/08/2023
Section Cited
1796.43
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(a) 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.
Type B
08/18/2023
Section Cited
1796.44
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(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.
08/08/2023
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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: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
LIC809 (FAS) - (06/04)
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