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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 104700031
Report Date: 06/07/2024
Date Signed: 06/20/2024 11:24:42 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/27/2024 and conducted by Evaluator Ruben Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 47-HC-20240327110532
FACILITY NAME:EVERLIGHT CAREFACILITY NUMBER:
104700031
ADMINISTRATOR:AZAMIAN, SHIREENFACILITY TYPE:
300
ADDRESS:7191 N INGRAM AVE SUITE 103TELEPHONE:
(559) 353-2847
CITY:FRESNOSTATE: CAZIP CODE:
93650
CAPACITY:CENSUS: DATE:
06/07/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Kathy ValleyTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Home Care Aides do not have a fingerprint clearance.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Associate Governmental Program Analysts (AGPA) Ruben Perez spoke with designee Kathy Valley via phone/email, to discuss the above complaint allegation. The complaint investigation began on 4/12/2024 and analyst was able to review and finalize the additional documnetation that was provided by the HCO. Kathy was able to provide documentation (payroll and personnel folders) that concluded the Home Care Organization did not violate the allegation above.

Based on AGPA's observations and interviews, the AGPA concluded that there was not enough evidence to show that the organization violated the allegation listed above, therefore, the above allegation is found to be UNSUBSTANTIATED.

Analyst Perez concluded the visit with an exit interview and provided a copy of the report along with appeal rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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