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Department of
SOCIAL SERVICES

Community Care Licensing


HOME CARE ORGANIZATION EVALUATION REPORT

Facility Number: 574700009
Report Date: 08/02/2024
Date Signed: 08/02/2024 04:28:29 PM

Document Has Been Signed on 08/02/2024 04:28 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:WE CARE 4 YOLOFACILITY NUMBER:
574700009
ADMINISTRATOR/
DIRECTOR:		KELLI VILLANUEVAFACILITY TYPE:
300
ADDRESS:846 W MAIN STTELEPHONE:
(530) 564-6229
CITY:WINTERSSTATE: CAZIP CODE:
95694
CAPACITY: CENSUS: DATE:
08/02/2024
Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Kelli VillanuevaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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Associate Government Program Analysts (AGPAs) Megan Vigil and Ramsey Chimienti conducted a meeting over the phone with Licensee, Kelli Villanueva to review the report findings below.

Through evidence collected and interviews conducted, the Analysts concluded that Kelli hired and provided caregivers to a client where ongoing abuse was suspected and observed. Caregivers also indicated that they observed the client being physically and mentally abused. The licensee failed to report suspected abuse as required by state licensure. Licensee advised caregivers not to report the abuse that was occurring.

Upon file review, a copy of the caregiver schedule was requested to verify current TB test dates. After being cited for TB clearance deficiencies on the prior inspection, AGPA's discovered caregivers were scheduled back on shift and provided services to clients without a TB test clearance.

AGPA Vigil and Chimienti, informed the Licensee of the deficiencies found and explained that they would be noted on the 809D with a plan of correction. AGPA's Vigil and Chimienti concluded the visit with an exit interview with the Licensee and provided a copy of the HCS 809 and HCS 809D reports along with appeal rights.

LICENSING EVALUATOR NAME: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2024
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 08/02/2024 04:28 PM - It Cannot Be Edited


Created By: Megan Vigil On 08/02/2024 at 08:28 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: WE CARE 4 YOLO
FACILITY NUMBER: 574700009

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2024
Section Cited
1796.42
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...(e) Report any suspected or known dependent adult or elder abuse as required... A copy of each suspected abuse report shall be maintained and available for review by the department during normal business hours.
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Licensee did not report abuse that occurred and advised Home Care Aides to not report any incidents for a specific client. This poses an immediate Health and Safety risk to persons in care.
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Type A
08/02/2024
Section Cited
1796.45
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(d) After each 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.
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Licensee scheduled Home Care Aides who provided services to the public without TB clearance after being cited on the previous inspection. This 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: Megan Vigil
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2024
LIC809 (FAS) - (06/04)
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