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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700112
Report Date: 06/13/2024
Date Signed: 06/13/2024 01:42:46 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
02/23/2024 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20240223110118
FACILITY NAME:1HEART CAREGIVER SERVICESFACILITY NUMBER:
194700112
ADMINISTRATOR:TAGARAO, KEVINFACILITY TYPE:
300
ADDRESS:16530 VENTURA BLVD STE 500TELEPHONE:
(818) 906-4441
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:CENSUS: DATE:
06/13/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kevin Tagarao, Licensee TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Home Care Organization did not ensure Home Care Aides have completed the required training hours.
INVESTIGATION FINDINGS:
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The complainant alleged home care organization did not ensure home care aides have completed the required training hours.

During today’s visit, HCSA interviewed 2 staff including the licensee. The 2 staff stated they required newly hired HCAs to have background clearance and are registered with required training hours. According to Staff 2(S2) who does the recruitment and hiring of office staff and HCAs. The requirements upon hire were to complete the required trainings, registered on the home care aid registry and current TB clearance.
HCSA reviewed 10 home care aid files. The 5 of 10 HCA files did not have the required training on file.

Based on interviews conducted and file review, the complaint alleging home care organization did not ensure home care aides have completed the required training hours is found to be substantiated.
Health and safety code 1796.44(a) Training Requirements is being cited on the attached HCS 9099D. The 9099 and 9099D reports along with appeal rights were provided to the designee, Rica Te.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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 3
Control Number 47-HC-20240223110118
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: 1HEART CAREGIVER SERVICES
FACILITY NUMBER: 194700112
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/20/2024
Section Cited
1796.44(a)
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1796.44 Training Requirements
(a) A licensee shall ensure that prior to providing home care services, an affiliated home care aide shall complete the training requirements...
This requirement is not met as evidence by:
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Designee, Rica Te will submit proof of the missing training hours for HCA and email to the assigned analyst, Karen Ng by due date of 6/20/24.
Karen.Ng@dss.ca.gov
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Based on file review, 5 of 10 HCA files did not have the required hours of training. This posses a potential safety risk to children 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.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
02/23/2024 and conducted by Evaluator Mila Quinto
COMPLAINT CONTROL NUMBER: 47-HC-20240223110118

FACILITY NAME:1HEART CAREGIVER SERVICESFACILITY NUMBER:
194700112
ADMINISTRATOR:TAGARAO, KEVINFACILITY TYPE:
300
ADDRESS:16530 VENTURA BLVD STE 500TELEPHONE:
(818) 906-4441
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY:CENSUS: DATE:
06/13/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Kevin Tagarao, Licensee TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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9
Home Care Aides did not have fingerprint clearance prior to caring for clients.
Home Care Aides do not have tuberculosis (TB) clearance.
INVESTIGATION FINDINGS:
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The complainant alleged home care aides did not have fingerprint clearance prior to caring for clients, home care aides do not have tuberculosis (TB) clearance.

During today’s visit, HCSA interviewed 2 staff including the licensee. The 2 staff stated they required newly hired HCA’s to have background clearance and are registered. According to Staff 2(S2) who does the recruitment and hiring of office staff and HCAs, the requirements upon hire were to complete the required trainings, registered on the home care aid registry and current TB clearance.
HCSA reviewed 10 home care aid files and all files reviewed have fingerprint clearance with current TB clearance.
Based on interviews conducted and file review, the complaint alleging home care aids do not have a fingerprint clearance prior to caring for clients, do not have tuberculosis are found to be unsubstantiated. Although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3