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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700065
Report Date: 08/12/2025
Date Signed: 08/12/2025 05:07:04 PM

Substantiated


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
08/07/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20250807103920
FACILITY NAME:DAVIS IN-HOME CARE, INC.FACILITY NUMBER:
194700065
ADMINISTRATOR:DREW C. DAVISFACILITY TYPE:
300
ADDRESS:2627 MANHATTAN BEACH BLVD #204TELEPHONE:
(310) 297-9127
CITY:REDONDO BEACHSTATE: CAZIP CODE:
90278
CAPACITY:CENSUS: DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Drew Davis (Licensee), Robin Armantrout (Schedule Administrator), Lesly Pineda (Staff Coordinator)TIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Home Care Aides do not have a fingerprint clearance or exemption.

INVESTIGATION FINDINGS:
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On 8/12/25, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted an investigation visit regarding the above complaint allegation. EA met with licensee Drew Davis, Schedule Administrator Robin Armantrout, and Staff Coordinator Lesly Pineda.

During today's visit EA reviewed 10 home care aide (HCA) files and interviewed Mr. Davis, Ms. Armantrout, and Ms. Pineda. One of the 10 HCAs whose files were reviewed did not have fingerprint clearance, based on timesheet reviewed and interviews conducted HCA was assigned to two clients while fingerprint clearance was pending.

(see pg2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 47-HC-20250807103920
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME: DAVIS IN-HOME CARE, INC.
FACILITY NUMBER: 194700065
VISIT DATE: 08/12/2025
NARRATIVE
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Page 2

Based on records reviewed and interviews conducted the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. Health and Safety Code, Division 2, Chapter 13, Section 1796.23(a) is being cited on the attached HCS 9099D. Licensee was advised that HCAs must be fingerprint cleared before placing them with clients.

EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 47-HC-20250807103920
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
HOME CARE SERVICES, 744 P STREET, MS 09-14-90
SACRAMENTO, CA 95814
FACILITY NAME: DAVIS IN-HOME CARE, INC.
FACILITY NUMBER: 194700065
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/26/2025
Section Cited
1796.23(a)
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1796.23(a) Fingerprint Requirements. Each person initiating a background examination to be a registered home care aide shall submit their fingerprints to the Department of Justice by electronic transmission in a manner approved by the department...
This requirement is not met as evidenced by:
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According to the licensee, S1 is currently not working while the fingerprint clearance is in process. Licensee will submit a written plan of correction to indicate licensee's plan to ensure all HCAs have a cleared criminal
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Based on interviews and records reviewed home care aide S1 not have fingerprint clearance before being placed with clients which poses an immediate health & safety risk to clients in care.
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background clearance before being placed with clients which is to be submitted to EA Ryan Chan (ryan.chan@dss.ca.gov).
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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.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
08/07/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20250807103920

FACILITY NAME:DAVIS IN-HOME CARE, INC.FACILITY NUMBER:
194700065
ADMINISTRATOR:DREW C. DAVISFACILITY TYPE:
300
ADDRESS:2627 MANHATTAN BEACH BLVD #204TELEPHONE:
(310) 297-9127
CITY:REDONDO BEACHSTATE: CAZIP CODE:
90278
CAPACITY:CENSUS: DATE:
08/12/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Drew Davis (Licensee), Robin Armantrout (Schedule Administrator), Lesly Pineda (Staff Coordinator)TIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Home Care Aide did not have proper training.
INVESTIGATION FINDINGS:
1
2
3
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5
6
7
8
9
10
11
12
13
On 8/12/25, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan conducted an investigation visit regarding the above complaint allegation. EA met with licensee Drew Davis, Schedule Administrator Robin Armantrout, and Staff Coordinator Lesly Pineda.

During today's visit EA reviewed 10 home care aide (HCA) files and interviewed Mr. Davis, Ms. Armantrout, and Ms. Pineda. All 10 HCAs whose files were reviewed have completed the training required under Health and Safety Code Section 1796.44.

Based on the evidence gathered and interviews conducted, the preponderance of evidence standard has not been met, therefore the above allegation is found to be UNSUBSTANTIATED.

EA concluded the visit with an exit interview and provided a copy of this report along with appeal rights to the licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4