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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 564700101
Report Date: 07/06/2026
Date Signed: 07/06/2026 01:43:21 PM

Document Has Been Signed on 07/06/2026 01:43 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:HEART OF ANGELSFACILITY NUMBER:
564700101
ADMINISTRATOR/
DIRECTOR:		BRITTANY WHITEFACILITY TYPE:
300
ADDRESS:1200 PASEO CAMARILLO #185TELEPHONE:
(805) 647-8616
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: CENSUS: DATE:
07/06/2026
Required - 2 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:08 PM
MET WITH:Brittany WhiteTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
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Home Care Services Bureau (HCSB) analyst, Ruben Perez, arrived at the business office of Heart Of Angels for an in-person biennial inspection on 7/6/2026. Upon arrival, the HCSB analyst identified himself and was greeted by Brittany White. 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 licensee. The analyst informed Brittany of the deficiencies found and explained they would be noted on the 809D.
NAME OF LICENSING PROGRAM ANALYST: Ruben Perez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2026
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 07/06/2026 01:43 PM - It Cannot Be Edited


Created By: Ruben Perez On 07/06/2026 at 12:59 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: HEART OF ANGELS
FACILITY NUMBER: 564700101

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2026
Section Cited
1796.45
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(a) 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. TB clearance was not documented in the personnel records of caregiver(s) REF# 02,03,04,06 in the 859-report reviewed by the Enforcement Analyst. Failure to maintain documentation of TB clearance poses an immediate health and safety risk to clients in care.
Type A
07/28/2026
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. Proof of Clearance was not documented in the personnel records of caregiver(s) REF# 01,02, in the 859-report reviewed by the Enforcement Analyst. Failure to maintain documentation showing proof of clearance for all home care aides poses an immediate health and safety risk to clients in care.
Type B
07/28/2026
Section Cited
1796.44
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(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 their role as home care aide 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.
(6) The special care needs of clients with dementia. Training requirements were not documented in the personnel records of caregiver(s) REF# 01,02,03,04,05,06 in the 859-report reviewed by the Enforcement Analyst. Failure to maintain documentation of completed training poses an immediate health and safety risk to clients in care.
Type B
07/28/2026
Section Cited
1796.42
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(b) Maintain and abide by a valid workers’ compensation policy covering its affiliated home care aides.
(c) Maintain and abide by an employee dishonesty bond, including third-party coverage, with a minimum limit of ten thousand dollars ($10,000).
(d) Maintain proof of general and professional liability insurance in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the aggregate.
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: Ruben Perez
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2026
LIC809 (FAS) - (06/04)
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