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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006112
Report Date: 05/26/2026
Date Signed: 05/26/2026 01:33:30 PM

Document Has Been Signed on 05/26/2026 01:33 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:ABK SWEET HOMECARE INC.FACILITY NUMBER:
306006112
ADMINISTRATOR/
DIRECTOR:		TRUONG, BRENDAFACILITY TYPE:
740
ADDRESS:10171 NORTHAMPTON AVETELEPHONE:
(714) 837-9198
CITY:WESTMINSTERSTATE: CAZIP CODE:
92683
CAPACITY: 6CENSUS: 6DATE:
05/26/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Brenda Truong, Lily NguyenTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Michael Tea conducted an unannounced annual inspection visit to the facility. LPA Tea was greeted and granted entry by caregiver staff and explained the purpose of the visit. Administrator (AD) Kristine Truong and Licensee (LE) Lily Nguyen arrived shortly thereafter to assist with the inspection. The facility is licensed for a capacity of six residents, approved for one ambulatory and five non-ambulatory residents, with a hospice waiver for four residents. At the time of today’s visit, there were six residents residing at the facility, including one resident receiving hospice services.

LPA Tea reviewed six resident files and three staff files. All required documentation was present in the files reviewed. Administrator Kristine Truong’s administrator certificate expires on January 17, 2028.

LPA Tea, accompanied by AD Truong and care staff, conducted a tour of the physical plant, including resident bedrooms, bathrooms, common areas, kitchen, food supply, medication storage, and outside grounds. The facility is a two-story home consisting of five resident bedrooms, two full bathrooms, living room, kitchen, dining area, and attached garage. The second floor is designated for staff use only. LPA observed smoke detectors and carbon monoxide detectors in common areas and resident bedrooms to be operational. Resident bedrooms contained the required furniture, linens, and adequate closet and drawer space to accommodate residents comfortably. Bathrooms were clean. Toilets and faucets operated properly, grab bars were secure, and showers were free of mold and mildew. The hot water temperature measured 106.3 degrees Fahrenheit, which was within the required range. Resident hygiene supplies, toiletries, and bath towels were adequately stocked at the time of the visit. Common areas were clean, organized, and free of hazards or obstructions. The first aid kit was inspected and contained all required items, including bandages, dressings, scissors, tweezers, and a thermometer. Kitchen appliances

(Annual Inspection report continued on LIC809C)

NAME OF LICENSING PROGRAM MANAGER: Lourdes Montoya
NAME OF LICENSING PROGRAM ANALYST: Michael Tea
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: ABK SWEET HOMECARE INC.
FACILITY NUMBER: 306006112
VISIT DATE: 05/26/2026
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were operational during today’s visit. Perishable and non-perishable food supplies were reviewed and found to be adequately stocked. LPA observed emergency food and water supplies stored in the kitchen and garage. Sharps were secured in a kitchen drawer, and toxic substances were locked and inaccessible to residents beneath the kitchen sink and inside the garage. Fire extinguishers throughout the facility were fully charged. The last documented fire drill was conducted on March 8, 2026.

LPA toured the outside grounds and observed new patio furniture with an umbrella to provide outdoor seating and shade for residents. Side gates were self-latching and functioning properly. The facility provides activities based on residents’ individual preferences, health conditions, and limitations. Activities include music therapy, chair exercises, group discussions, and arts and crafts. An activity person also visits the facility periodically. During today’s visit, LPA observed residents watching television in the living room and eating lunch.

LPA reviewed medication storage and administration practices. Medications were observed to be centrally stored in a locked cabinet in the kitchen and administered according to physician’s orders. LPA was unable to interview residents regarding their quality of care due to residents’ health conditions and language barriers. LPA Tea interviewed staff regarding the care and services being provided to residents.

Based on observations made during today’s inspection, no deficiencies were cited in the areas inspected under Title 22, Division 6 of the California Code of Regulations.

This report was reviewed with the facility. A copy of LIC 809, LIC 809-C, LIC 858, LIC 859, and LIC 9102TV was provided to the facility.

NAME OF LICENSING PROGRAM MANAGER: Lourdes Montoya
NAME OF LICENSING PROGRAM ANALYST: Michael Tea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2026
LIC809 (FAS) - (06/04)
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