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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 104700045
Report Date: 05/15/2025
Date Signed: 05/20/2025 10:20:20 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
04/02/2025 and conducted by Evaluator Ruben Perez
COMPLAINT CONTROL NUMBER: 47-HC-20250402125251
FACILITY NAME:ANGELICARE IN HOME COMPANION CARE, INC.FACILITY NUMBER:
104700045
ADMINISTRATOR:SISK, KRISFACILITY TYPE:
300
ADDRESS:4840 N. FIRST ST, SUITE 110TELEPHONE:
(559) 453-0151
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:CENSUS: DATE:
05/15/2025
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Kris SiskTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
HCO does not ensure that staff are providing services to client as contracted.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 15, 2025, Enforcement Analyst (EA) Ruben Perez arrived at the business address for Angelicare In Home Companion Care. EA Perez introduced himself and was greeted by Kris Sisk. EA Perez explained that he was there to investigate the complaint allegation(s) referenced above. During the visit, EA Perez interviewed the designated representative regarding the company’s caregiver onboarding process, including procedures for conducting background checks and ensuring registration on the Home Care Aide (HCA) Registry. EA Perez also conducted a review of personnel files and payroll records to verify compliance with licensing requirements. Additionally, EA Perez inquired about the company’s policies related to Home Care Aides failing to report for scheduled shifts. The designee was able to provide the following documentation:
• A Client Service Agreement, which outlines policies related to service interruptions,
• An Employee Handbook, which includes attendance and punctuality requirements set forth by the company.
EA Perez also received a police report from the Fresno County Sheriff’s Office regarding a similar complaint. According to the report, the investigating detective found the complaint to be unsubstantiated.

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

Analyst Perez concluded the visit with an exit interview and provided a copy of the HCS 9099 investigation report along with appeal rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wendy Scott
LICENSING EVALUATOR NAME: Ruben Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025
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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