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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 194700115
Report Date: 06/03/2025
Date Signed: 06/03/2025 10:12:38 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
04/14/2025 and conducted by Evaluator Ryan Chan
COMPLAINT CONTROL NUMBER: 47-HC-20250414093150
FACILITY NAME:SAVING GRACE CARE, LLCFACILITY NUMBER:
194700115
ADMINISTRATOR:MONTANO, SANDRAFACILITY TYPE:
300
ADDRESS:3601 E. HOLT AVE UNIT ATELEPHONE:
(626) 475-8657
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:CENSUS: DATE:
06/03/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sandra Montano - LicenseeTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Home Care Aides are administering medications to residents in care
INVESTIGATION FINDINGS:
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On 6/3/25, Home Care Services Branch Enforcement Analyst (EA), Ryan Chan arrived at Saving Grace Care to deliver the finding for the allegation listed above. Upon arrival, EA met with licensee Sandra Montano.

Reporting party (RP) alleged that home care aides (HCA) were dispensing and administering medication to clients. During the investigation, EA reviewed list of clients and assigned home care aides (HCA), EA interviewed licensee and 11 HCAs. All 11 HCAs denied administering medication, they indicated they only remind clients by telling them to take their medication. If the client has a pill box, HCAs will hand the pill box to the client if client asks. HCAs stated pill boxes are filled by client’s family members or a nurse if client has a nurse. One HCA stated that at the request of her client she will place the pills from the pill box into a cup to make the pills easier for client to take themselves.

(see pg 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
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 2
Control Number 47-HC-20250414093150
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: SAVING GRACE CARE, LLC
FACILITY NUMBER: 194700115
VISIT DATE: 06/03/2025
NARRATIVE
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page 2

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.
SUPERVISORS NAME: Susan Du
LICENSING EVALUATOR NAME: Ryan Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2